[Interventional cardiology methods in the treatment of ventricular arrhythmia]

Sustained ventricular arrhythmias are the primary cause of sudden death in France. Treatment possibilities have increased in recent years with the development of interventional rhythmology techniques. Thus alongside the classical pharmacological approach, clinicians now have access to more aggressive treatment methods such as implantable pacing-defibrillation systems or endocavitary excision techniques. Implantable defibrillation systems are of proven efficacy in reducing ventricular arrhythmias but their action is merely palliative. Technological advances have simplified their implantation and increased their diagnostic and therapeutic abilities. Their high price is nevertheless one of the factors limiting their wider use in some countries. Endocavitary excision techniques, with a radical curative effects, are used only in cases of sustained monomorphous ventricular tachycardia in the absence of any associated cardiac surgery procedure. Coronary angioplasty is of rhythmological value when the etiopathogenesis of the arrhythmia is of proven ischemic origin. Rather than being competitors, these various methods are complementary, each having specific characteristics forming the basis of particular indications.