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Ventricular Arrhythmias and Heart Failure

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Heart Failure

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Abstract

Sudden death accounts for a significant number of deaths in heart failure patients. A majority of sudden deaths in heart failure are from ventricular tachyarrhythmias. Ventricular tachycardia is common in heart failure patients and the approach to its evaluation and treatment requires special attention. Unique pathophysiologic changes in cardiomyopathy and heart failure predispose these patients to the development of ventricular arrhythmias. Specifically targeting these changes can be beneficial when developing treatment strategies for ventricular tachycardia in heart failure. In this chapter, we will review the mechanisms of arrhythmogenesis as they relate to the heart failure syndrome, the different clinical manifestations of ventricular arrhythmias in heart failure, as well as the most appropriate methods for treating ventricular arrhythmias in heart failure patients to prevent recurrent arrhythmias and sudden cardiac death.

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Abbreviations

AAD:

Antiarrhythmic drug

ARB:

Angiotensin receptor blocker

ARVC:

Arrhythmogenic right ventricular cardiomyopathy

BBRVT:

Bundle branch reentrant ventricular tachycardia

CMR:

Cardiovascular magnetic resonance

DAD:

Delayed after-depolarization

EAD:

Early after-depolarization

ECG:

Electrocardiogram

HCM:

Hypertrophic cardiomyopathy

HPS:

His-Purkinje system

ICD:

Implantable cardioverter-defibrillator

LCSD:

Left cardiac sympathetic denervation

LGE:

Late gadolinium enhancement

LVEF:

Left ventricular ejection fraction

MI:

Myocardial infarction

NSVT:

Nonsustained ventricular tachycardia

RAAS :

Renin-angiotensin-aldosterone system

RFA:

Radiofrequency ablation

SCD:

Sudden cardiac death

SR:

Sarcoplasmic reticulum

VAD:

Ventricular assist device

VF:

Ventricular fibrillation

VNS:

Vagal nerve stimulation

VPDs:

Ventricular premature depolarizations

VT:

Ventricular tachycardia

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Authors and Affiliations

  1. Cardiac Electrophysiologist, University of Colorado Health, 2121 East Harmony Road, Suite 100, Fort Collins, CO, 80528, USA

    Ethan R. Ellis MD

  2. Harvard Medical School, Cardiovascular Division, Beth Israel Deaconess Medical Center Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, 330 Brookline Avenue, Boston, MA, 02215, USA

    Mark E. Josephson MD

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  1. Division of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA

    Howard Eisen

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Ellis, E.R., Josephson, M.E. (2017). Ventricular Arrhythmias and Heart Failure. In: Eisen, H. (eds) Heart Failure. Springer, London. https://doi.org/10.1007/978-1-4471-4219-5_15

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