Kattel Sharma, Enriquez Alan D
Cardiovascular Medicine, Yale University School of Medicine, PO Box 208017, New Haven, CT, 06520-8017, USA.
J Interv Card Electrophysiol. 2023 Apr;66(3):793-805. doi: 10.1007/s10840-022-01363-1. Epub 2022 Sep 3.
Nonischemic cardiomyopathy (NICM) comprises a heterogenous group of disorders with myocardial dysfunction unrelated to significant coronary disease. As the use of implantable defibrillators has increased in this patient population, catheter ablation is being utilized more frequently to treat NICM patients with ventricular tachycardia (VT). Progress has been made in identifying multiple subtypes of NICM with variable scar patterns. The distribution of scar is often mid-myocardial and subepicardial, and identifying and ablating this substrate can be challenging. Here, we will review the current understanding of NICM subtypes and the outcomes of VT ablation in this population. We will discuss the use of cardiac imaging, electrocardiography, and electroanatomic mapping to define the VT substrate and the ablation techniques required to successfully prevent VT recurrence.
非缺血性心肌病（NICM）是一组异质性疾病，其心肌功能障碍与严重冠状动脉疾病无关。随着植入式除颤器在该患者群体中的使用增加，导管消融术越来越频繁地用于治疗患有室性心动过速（VT）的NICM患者。在识别具有可变瘢痕模式的NICM多种亚型方面已取得进展。瘢痕分布通常在心肌中层和心外膜下，识别和消融该基质可能具有挑战性。在此，我们将综述目前对NICM亚型的认识以及该人群中VT消融的结果。我们将讨论使用心脏成像、心电图和电解剖标测来定义VT基质以及成功预防VT复发所需的消融技术。
