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Ventricular tachycardia in repaired congenital heart disease

Ventricular arrhythmias are an important cause of late morbidity and sudden cardiac death in the growing population of adults with repaired congenital heart disease. Risk stratification remains challenging because of the heterogeneity of the malformations and the surgical approaches. Therapeutic int...

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Detalles Bibliográficos
Autor principal: Zeppenfeld, Katja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894933/
https://www.ncbi.nlm.nih.gov/pubmed/27193903
http://dx.doi.org/10.1007/s00399-016-0428-4
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author Zeppenfeld, Katja
author_facet Zeppenfeld, Katja
author_sort Zeppenfeld, Katja
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description Ventricular arrhythmias are an important cause of late morbidity and sudden cardiac death in the growing population of adults with repaired congenital heart disease. Risk stratification remains challenging because of the heterogeneity of the malformations and the surgical approaches. Therapeutic interventions depend on the type of ventricular arrhythmia, which can be polymorphic ventricular tachycardia (VT) or ventricular fibrillation in patients without ventricular scars, but also potentially fatal monomorphic reentrant VTs, typical for patients with ventricular scars or obstacles. Advances in surgical techniques have improved survival and have important implications for the arrhythmia substrates and prognosis. Over the past few decades, progress has been made to determine the anatomical basis for monomorphic VT in patients with ventricular surgical scars and patch material. These substrates can be currently identified and targeted during sinus rhythm by radiofrequency catheter or surgical ablation without the need for VT induction. The review provides an update on the evolving surgical approaches, the changing VA substrates, and the potential consequences for individualized risk assessment and tailored treatment.
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spelling pubmed-48949332016-06-20 Ventricular tachycardia in repaired congenital heart disease Zeppenfeld, Katja Herzschrittmacherther Elektrophysiol Schwerpunkt Ventricular arrhythmias are an important cause of late morbidity and sudden cardiac death in the growing population of adults with repaired congenital heart disease. Risk stratification remains challenging because of the heterogeneity of the malformations and the surgical approaches. Therapeutic interventions depend on the type of ventricular arrhythmia, which can be polymorphic ventricular tachycardia (VT) or ventricular fibrillation in patients without ventricular scars, but also potentially fatal monomorphic reentrant VTs, typical for patients with ventricular scars or obstacles. Advances in surgical techniques have improved survival and have important implications for the arrhythmia substrates and prognosis. Over the past few decades, progress has been made to determine the anatomical basis for monomorphic VT in patients with ventricular surgical scars and patch material. These substrates can be currently identified and targeted during sinus rhythm by radiofrequency catheter or surgical ablation without the need for VT induction. The review provides an update on the evolving surgical approaches, the changing VA substrates, and the potential consequences for individualized risk assessment and tailored treatment. Springer Berlin Heidelberg 2016-05-19 2016 /pmc/articles/PMC4894933/ /pubmed/27193903 http://dx.doi.org/10.1007/s00399-016-0428-4 Text en © The Author(s) 2016 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Schwerpunkt
Zeppenfeld, Katja
Ventricular tachycardia in repaired congenital heart disease
title Ventricular tachycardia in repaired congenital heart disease
title_full Ventricular tachycardia in repaired congenital heart disease
title_fullStr Ventricular tachycardia in repaired congenital heart disease
title_full_unstemmed Ventricular tachycardia in repaired congenital heart disease
title_short Ventricular tachycardia in repaired congenital heart disease
title_sort ventricular tachycardia in repaired congenital heart disease
topic Schwerpunkt
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894933/
https://www.ncbi.nlm.nih.gov/pubmed/27193903
http://dx.doi.org/10.1007/s00399-016-0428-4
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