Gössinger H, Kreiner G, Heinz G, Siostrzonek P
Klinischen Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Wien.
Wien Med Wochenschr. 1994;144(14-15):353-67.
The widespread application of catheter ablation techniques has significantly affected the meaning of non-invasive evaluation of both supraventricular and ventricular tachycardias. In patients with different forms of supraventricular tachycardias radiofrequency current ablation offers comparable high success rates. Therefore, since non-invasive and invasive classification of supraventricular tachycardias agree only in 80% of patients, the diagnosis based on non-invasive means may constitute a bias, but does not obviate the need for a scrutinized preablation electrophysiologic study to determine the very type of tachycardia. In contrast, in patients with ventricular tachycardias a manyfold of different therapies is available: antiarrhythmic drug medication, catheter ablation or surgical intervention including the implantation of programmable cardioverters/defibrillators. The selection of the optimal therapy, however, is predominantly dependent on the clinical presentation of tachycardia, on the type and the severity of the underlying structural heart disease and on the potential mechanism of tachycardia.
导管消融技术的广泛应用显著影响了室上性和室性心动过速无创评估的意义。对于不同形式的室上性心动过速患者，射频电流消融提供了相当高的成功率。因此，由于室上性心动过速的无创和有创分类仅在80%的患者中一致，基于无创手段的诊断可能构成偏差，但并不能消除在消融前进行仔细的电生理研究以确定心动过速确切类型的必要性。相比之下，对于室性心动过速患者，有多种不同的治疗方法可供选择：抗心律失常药物治疗、导管消融或手术干预，包括植入可编程心脏复律除颤器。然而，最佳治疗方法的选择主要取决于心动过速的临床表现、潜在结构性心脏病的类型和严重程度以及心动过速的潜在机制。
