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Expert consensus on acute management of ventricular arrhythmias - VT network Austria
M Martinek1,2, M Manninger3, R Schönbauer4
1Ordensklinikum Linz Elisabethinen, Interne 2 mit Kardiologie, Angiologie und Intensivmedizin, Fadingerstrasse 1, 4020 Linz, Austria.
Insights
Austrian cardiologists aim to improve acute care for ventricular arrhythmias (VA), including ventricular tachycardia (VT) and ventricular fibrillation (VF). A new network of primary and secondary VT centers will implement national guidelines for diagnosis and treatment, including ablation therapy.
Area of Science:
- Cardiology
- Electrophysiology
- Health Systems Management
Background:
- Ventricular arrhythmias (VA), including ventricular tachycardia (VT) and ventricular fibrillation (VF), require systematic acute care.
- Current ESC guidelines recommend acute ablation for specific VA cases like scar-associated incessant VT, electrical storm (ES), and ischemic cardiomyopathy (iCMP) with recurrent ICD shocks.
Purpose of the Study:
- To systematically structure and organize the acute care of patients with VA in Austria.
- To establish national recommendations for the diagnosis and treatment of VA.
- To implement organizational measures for guideline adherence, including the creation of a VT network.
Main Methods:
- Development of a consensus paper outlining national recommendations for VA diagnosis and treatment.
- Definition of organizational aspects for an acute VT network.
- Categorization of participating centers into primary and secondary VT centers based on predefined criteria.
Main Results:
- National recommendations for basic diagnostic work-up (ECG, history, labs, echo, etc.) and further treatment (coronary angiography, ablation) for VA have been established.
- An organizational framework for an acute VT network across Austria, comprising primary and secondary VT centers, has been defined.
- Integration of all Austrian electrophysiology centers involved in VT ablation into the network is planned.
Conclusions:
- The establishment of a structured VT network is crucial for implementing current guidelines on acute VA care.
- A collaborative network of primary and secondary VT centers will enhance the management of patients with ventricular arrhythmias.
- Standardized diagnostic and therapeutic pathways are essential for improving outcomes in acute VA cases.
Abstract:
The Arrhythmia Working Group of the Austrian Society of Cardiology (ÖKG) has set the goal of systematically structuring and organizing the acute care of patients with ventricular arrhythmias (VA), i.e. ventricular tachycardia (VT) or ventricular fibrillation (VF) in Austria. Within a consensus paper, national recommendations on the basic diagnostic work-up of VA (12-lead ECG, medical history, family history, laboratory analyses, echocardiography, search for reversible causes, ICD interrogation), as well as further medical treatment and therapeutic measures (indication of coronary angiography, ablation therapy) are established. Since acute ablation of VT is indicated in the current ESC guidelines as a class IB indication for scar-associated incessant VT or electrical storm (ES; ≥ 3 ICD therapies in 24 h) as well as for ischemic cardiomyopathy (iCMP) with recurrent ICD shocks, organizational measures must be taken to ensure that these guidelines can be implemented. Therefore, a VT network will be established covering all areas in Austria, consisting of primary and secondary VT centers. Organizational aspects of an acute VT network are defined and should subsequently be implemented by the participating hospitals. All electrophysiologic centers in Austria that deal with VT ablation are to be integrated into the network in the medium-term. Centers that co-operate in the network are divided into primary and secondary VT centers according to predefined criteria.