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Current Therapies for Ventricular Tachycardia: Are there Autonomic Implications of the Arrhythmogenic Substrate?

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Heart Failure Management: The Neural Pathways

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Abstract

In the last two decades, significant advances have been made in diagnosis, understanding, and treatment of various ventricular arrhythmias (VA). Years ago, in its infancy, the field of cardiac electrophysiology was limited to the study of the effects of antiarrhythmic drugs on ventricular programmed stimulation in the setting of various disease states. However, modern scientific and technological advances not only have improved the characterization of the arrhythmia substrate but also have provided an opportunity to potentially cure many ventricular arrhythmias. Contemporary mapping systems, ablation catheters, and advanced intracardiac ultrasound technology have also significantly improved the efficacy and safety of ablation procedures. An increasing number of centers are embarking on a very exciting journey of ventricular tachycardia ablation programs, focusing on high-risk patients with low ejection fractions, as well as complex ablations involving epicardium, aortic cusps, and epicardial vessels. Patients who in the past would have otherwise had little chance of survival, now, with improvements in complex ablations, procedures can benefit from improved longevity and quality of life. Another recent significant advance has been the use of ventricular assist devices during the ablation of ventricular arrhythmias for high-risk patients with cardiogenic shock.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45219, USA

    Alexandru Costea MD

  2. Northwestern Medicine West Region, Faculty, Northwestern Feinberg School of Medicine, 25 North Winfield Road, Winfield, IL, 60190, USA

    Omeed Zardkoohi MD

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  1. Alexandru Costea MD
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Correspondence to Alexandru Costea MD .

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Editors and Affiliations

  1. Director of Cardiology Division, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy

    Edoardo Gronda

  2. Heart Failure Clinic, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy

    Emilio Vanoli

  3. University of Cincinnati, Cincinnati, Ohio, USA

    Alexandru Costea

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Costea, A., Zardkoohi, O. (2016). Current Therapies for Ventricular Tachycardia: Are there Autonomic Implications of the Arrhythmogenic Substrate?. In: Gronda, E., Vanoli, E., Costea, A. (eds) Heart Failure Management: The Neural Pathways. Springer, Cham. https://doi.org/10.1007/978-3-319-24993-3_4

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  • DOI: https://doi.org/10.1007/978-3-319-24993-3_4

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