Cojocaru Cosmin, Dorobanțu Maria, Vătășescu Radu
Department of Cardiothoracic Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Cardiology, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.
Rev Cardiovasc Med. 2024 Dec 5;25(12):432. doi: 10.31083/j.rcm2512432. eCollection 2024 Dec.
Catheter ablation-based management strategies for the drug-refractory electrical storm (ES) have been proven to abolish acute ventricular arrhythmic episodes and improve long-term outcomes. However, this effect is highly influenced by multiple independently acting factors, which, if identified and addressed, may allow a more tailored management to each particular case to improve results. This review synthesizes existing evidence concerning ES outcome predictors of patients undergoing ablation and introduces the role of novel scoring algorithms to refine risk stratification. The presence of these factors should be assessed during two distinct phases in relation to the ablation procedure: before (based on preprocedural multimodal evaluation of the patient's structural heart disease and comorbidities) and after the ablation procedure (in terms of information derived from the invasive substrate characterization, procedural results, postprocedural recurrences (spontaneous or during non-invasive testing), and complications).
基于导管消融的药物难治性电风暴(ES)管理策略已被证明可消除急性室性心律失常发作并改善长期预后。然而,这种效果受到多种独立作用因素的高度影响,如果识别并解决这些因素,可能会针对每个具体病例进行更有针对性的管理以改善结果。本综述综合了有关接受消融治疗患者的ES结局预测因素的现有证据,并介绍了新型评分算法在完善风险分层中的作用。应在与消融手术相关的两个不同阶段评估这些因素的存在情况:术前(基于对患者结构性心脏病和合并症的术前多模态评估)和消融手术后(根据从有创基质特征分析、手术结果、术后复发情况(自发或在无创检查期间)以及并发症中获得的信息)。