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Arrhythmias in structural heart disease

H Sawyer Gillespie1, Charles C H Lin, Jordan M Prutkin

  • 1Division of Cardiology, University of Washington, 1959 NE Pacific Street, Box 356422, Seattle, WA, 98195, USA.

Current Cardiology Reports
|June 22, 2014
PubMed

Insights

Structural heart disease often causes electrical heart abnormalities like arrhythmias. Treatment focuses on the underlying cause and may include medications, pacemakers, or implantable cardioverter-defibrillators (ICDs) to manage risks.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Structural heart disease is frequently linked to cardiac electrical abnormalities, specifically atrial and ventricular arrhythmias.
  • These arrhythmias can arise in patients with various conditions, including ischemic and non-ischemic cardiomyopathies, congenital heart disease, and other myocardial structural issues.

Purpose of the Study:

  • To outline the management strategies for arrhythmias associated with structural heart disease.
  • To emphasize the role of implantable cardioverter-defibrillators (ICDs) in managing life-threatening arrhythmias.

Main Methods:

  • Review of current therapeutic approaches for arrhythmias in structural heart disease.
  • Discussion of medical therapies, device-based interventions (pacemakers, ICDs), and ablation techniques.
  • Emphasis on patient selection and device choice for ICD therapy.

Main Results:

  • Treatment prioritizes addressing the underlying structural heart disorder through interventions like surgery or catheter-based procedures.
  • Pharmacological agents (beta-blockers, anti-arrhythmics), pacemakers, ICDs, and ablation are employed for prophylaxis or treatment.
  • ICDs are crucial for patients at risk of malignant arrhythmias, with careful selection vital for outcomes.

Conclusions:

  • Arrhythmias in structural heart disease require a multifaceted treatment approach, often beginning with addressing the primary cardiac abnormality.
  • Device selection and patient management are critical for optimizing the efficacy and safety of interventions like ICDs.
  • Therapeutic decisions, including prophylactic measures, are made based on arrhythmia risk and potential for adverse events, irrespective of symptom presence.

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