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Pathophysiology of ventricular tachyarrhythmias

From automaticity to reentry

Pathophysiologie ventrikulärer Tachyarrhythmien

Von der Automatizität zum Reentry

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Abstract

Ventricular arrhythmias are a heterogeneous group of arrhythmias and may arise in patients with cardiomyopathy or structurally normal hearts. The electrophysiologic mechanisms responsible for the initiation and maintenance of ventricular tachycardia include enhanced automaticity, triggered activity, and reentry. Differentiating between these three mechanisms can be challenging and usually requires an invasive electrophysiology study. Establishing the underlying mechanism in a particular patient is helpful to define the optimal therapeutic approach, including the selection of pharmacologic agents or delineation of an ablation strategy.

Zusammenfassung

Ventrikuläre Arrhythmien stellen eine heterogene Gruppe von Arrhythmien dar und können bei Patienten mit einer Kardiomyopathie oder mit strukturell normalem Herzen auftreten. Die elektrophysiologischen Mechanismen, die für den Beginn und das Anhalten ventrikulärer Tachykardien verantwortlich sind, beinhalten eine erhöhte Automatizität, Triggeraktivität und Reentry. Die Differenzierung dieser drei Mechanismen kann eine Herausforderung darstellen und bedarf in der Regel einer invasiven elektrophysiologischen Untersuchung. Die Etablierung des zugrunde liegenden Mechanismus bei einem bestimmten Patienten kann hilfreich sein, um die optimale Therapie zu finden, einschließlich der Wahl der Pharmazeutika oder dem Entwurf einer Ablationsstrategie.

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Authors and Affiliations

  1. Section of Cardiac Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Andres Enriquez MD & David S. Frankel MD

  2. Heart Rhythm Service, Kingston General Hospital, Queen’s University, Kingston, ON, Canada

    Adrian Baranchuk MD FACC FRCPC FCCS

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  1. Andres Enriquez MD
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  2. David S. Frankel MD
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  3. Adrian Baranchuk MD FACC FRCPC FCCS
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Correspondence to Adrian Baranchuk MD FACC FRCPC FCCS.

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A. Enriquez, D.S. Frankel, and A. Baranchuk declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Enriquez, A., Frankel, D.S. & Baranchuk, A. Pathophysiology of ventricular tachyarrhythmias. Herzschr Elektrophys 28, 149–156 (2017). https://doi.org/10.1007/s00399-017-0512-4

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