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缺血性心脏病室性心动过速的导管消融:已知与新视角。

Catheter Ablation of Ventricular Tachycardia in Ischemic Heart Disease: What Is Known and New Perspectives.

机构信息

Institut Clinic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Carrer de Villaroel 170, 08036, Barcelona, Catalonia, Spain.

Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.

出版信息

Curr Heart Fail Rep. 2024 Jun;21(3):174-185. doi: 10.1007/s11897-024-00656-y. Epub 2024 Mar 27.

Abstract

PURPOSE OF THE REVIEW

This review aims to evaluate current evidence regarding ventricular tachycardia ablation in patients with ischemic heart disease and explore novel approaches currently developing to improve procedural and long-term outcomes.

RECENT FINDINGS

Recently published trials (PARTITA, PAUSE-SCD, and SURVIVE-VT) have demonstrated the prognostic benefit of prophylactic ventricular tachycardia ablation compared to current clinical practice. Advanced cardiac imaging provides a valuable pre-procedural evaluation of the arrhythmogenic substrate, identifying ablation targets non-invasively. Advanced cardiac mapping techniques allow to better characterize arrhythmogenic substrate during ablation procedure. Emerging technologies like pulsed field ablation and ultra-low temperature cryoablation show promise in ventricular tachycardia ablation. Advancements in mapping techniques, ablation technologies, and pre-procedural cardiac imaging offer promise for improving ventricular tachycardia ablation outcomes in ischemic heart disease.

摘要

目的综述

本综述旨在评估缺血性心脏病患者室性心动过速消融的现有证据,并探讨目前正在开发的改善手术和长期预后的新方法。

最近的发现

最近发表的试验(PARTITA、PAUSE-SCD 和 SURVIVE-VT)表明,与目前的临床实践相比,预防性室性心动过速消融具有预后益处。先进的心脏成像技术提供了心律失常基质的有价值的术前评估,可无创地识别消融靶点。先进的心脏标测技术可在消融过程中更好地描述心律失常基质。脉冲场消融和超低温度冷冻消融等新兴技术在室性心动过速消融中显示出前景。映射技术、消融技术和术前心脏成像的进步为改善缺血性心脏病中心律失常消融的结果提供了希望。

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