肥厚型心肌病室性心律失常的导管消融治疗
Catheter Ablation for Ventricular Arrhythmias in Hypertrophic Cardiomyopathy.
作者信息
Subramanian Muthiah, Atreya Auras R, Yalagudri Sachin D, Shekar P Vijay, Saggu Daljeet Kaur, Narasimhan Calambur
机构信息
Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Mindspace Road, Gachibowli, Hyderabad 500032, India.
Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Mindspace Road, Gachibowli, Hyderabad 500032, India; Division of Cardiovascular Medicine, Electrophysiology Section, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
出版信息
Card Electrophysiol Clin. 2022 Dec;14(4):693-699. doi: 10.1016/j.ccep.2022.08.005.
Implantable cardioverter-defibrillators are the mainstay of therapy for prevention of sudden cardiac death in high-risk patients with hypertrophic cardiomyopathy (HCM). Catheter ablation is a useful option for patients with recurrent, drug refractory monomorphic ventricular tachycardia (VT), and device therapy. Compared with other nonischemic substrates, there are limited data on the role and outcomes of catheter ablation in HCM. The challenges of VT ablation in HCM patients include deep intramural and epicardial substrates, suboptimal power delivery, and higher recurrence due to progression of disease. Patient selection, using cardiac MRI scar localization, and optimizing ablation techniques can improve outcomes in these patients.
植入式心脏复律除颤器是预防肥厚型心肌病（HCM）高危患者心源性猝死的主要治疗手段。对于复发性、药物难治性单形性室性心动过速（VT）患者和器械治疗患者，导管消融是一种有用的选择。与其他非缺血性基质相比，关于导管消融在HCM中的作用和结果的数据有限。HCM患者VT消融的挑战包括壁内和心外膜深层基质、能量传递欠佳以及疾病进展导致的更高复发率。通过心脏磁共振成像疤痕定位进行患者选择并优化消融技术可改善这些患者的治疗结果。
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