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Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart

Sudden cardiac death (SCD) represents approximately 50% of all cardiovascular mortality in the United States. The majority of SCD occurs in individuals with structural heart disease; however, around 5% of individuals have no identifiable cause on autopsy. This proportion is even higher in those <...

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Autores principales: Christie, Simon, Idris, Sami, Bennett, Richard G., Deyell, Marc W., Roston, Thomas, Laksman, Zachary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219526/
https://www.ncbi.nlm.nih.gov/pubmed/37233167
http://dx.doi.org/10.3390/jcdd10050200
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author Christie, Simon
Idris, Sami
Bennett, Richard G.
Deyell, Marc W.
Roston, Thomas
Laksman, Zachary
author_facet Christie, Simon
Idris, Sami
Bennett, Richard G.
Deyell, Marc W.
Roston, Thomas
Laksman, Zachary
author_sort Christie, Simon
collection PubMed
description Sudden cardiac death (SCD) represents approximately 50% of all cardiovascular mortality in the United States. The majority of SCD occurs in individuals with structural heart disease; however, around 5% of individuals have no identifiable cause on autopsy. This proportion is even higher in those <40 years old, where SCD is particularly devastating. Ventricular fibrillation (VF) is often the terminal rhythm leading to SCD. Catheter ablation for VF has emerged as an effective tool to alter the natural history of this disease among high-risk individuals. Important advances have been made in the identification of several mechanisms involved in the initiation and maintenance of VF. Targeting the triggers of VF as well as the underlying substrate that perpetuates these lethal arrhythmias has the potential to eliminate further episodes. Although important gaps remain in our understanding of VF, catheter ablation has become an important option for individuals with refractory arrhythmias. This review outlines a contemporary approach to the mapping and ablation of VF in the structurally normal heart, specifically focusing on the following major conditions: idiopathic ventricular fibrillation, short-coupled ventricular fibrillation, and the J-wave syndromes—Brugada syndrome and early-repolarization syndrome.
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spelling pubmed-102195262023-05-27 Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart Christie, Simon Idris, Sami Bennett, Richard G. Deyell, Marc W. Roston, Thomas Laksman, Zachary J Cardiovasc Dev Dis Review Sudden cardiac death (SCD) represents approximately 50% of all cardiovascular mortality in the United States. The majority of SCD occurs in individuals with structural heart disease; however, around 5% of individuals have no identifiable cause on autopsy. This proportion is even higher in those <40 years old, where SCD is particularly devastating. Ventricular fibrillation (VF) is often the terminal rhythm leading to SCD. Catheter ablation for VF has emerged as an effective tool to alter the natural history of this disease among high-risk individuals. Important advances have been made in the identification of several mechanisms involved in the initiation and maintenance of VF. Targeting the triggers of VF as well as the underlying substrate that perpetuates these lethal arrhythmias has the potential to eliminate further episodes. Although important gaps remain in our understanding of VF, catheter ablation has become an important option for individuals with refractory arrhythmias. This review outlines a contemporary approach to the mapping and ablation of VF in the structurally normal heart, specifically focusing on the following major conditions: idiopathic ventricular fibrillation, short-coupled ventricular fibrillation, and the J-wave syndromes—Brugada syndrome and early-repolarization syndrome. MDPI 2023-05-02 /pmc/articles/PMC10219526/ /pubmed/37233167 http://dx.doi.org/10.3390/jcdd10050200 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Christie, Simon
Idris, Sami
Bennett, Richard G.
Deyell, Marc W.
Roston, Thomas
Laksman, Zachary
Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title_full Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title_fullStr Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title_full_unstemmed Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title_short Trigger and Substrate Mapping and Ablation for Ventricular Fibrillation in the Structurally Normal Heart
title_sort trigger and substrate mapping and ablation for ventricular fibrillation in the structurally normal heart
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219526/
https://www.ncbi.nlm.nih.gov/pubmed/37233167
http://dx.doi.org/10.3390/jcdd10050200
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