[Incessant or recurrent ventricular tachycardia. Indications for emergency ablation]
R Surber1, D Prochnau, H Kühnert
1Klinik für Innere Medizin I (Kardiologie, Angiologie, Pneumologie, Internistische Intensivmedizin), Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland. ralf.surber@med.uni-jena.de
Abstract:
Incessant ventricular tachycardia and "electrical storms" are emergencies, requiring urgent action in a close cooperation between critical care physicians and cardiologists. The leading cause of such events is advanced cardiac disease. Besides the patient's history, an ECG and, if applicable, an implantable cardioverter-defibrillator (ICD) interrogation is required for a reliable diagnosis. Further diagnostics include laboratory parameters, an echocardiogram, and possibly a coronary angiography. The medical therapy, consisting of amiodarone and β-blockers, should immediately be initiated after diagnosis. In the case of failed drug therapy, urgent catheter ablation is indicated. This is a complex procedure, in which the clinical tachycardia or the electrical substrate is modified by using an irrigated catheter. The acute success rate of this life-saving procedure is high. However, there might also be complications due to the required extensive procedures.
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