Zusammenfassung
Neben Vorhofflimmern und anderen supraventrikulären Herzrhythmusstörungen stehen ventrikuläre Tachykarden im zentralen Fokus der Kardiologie und Rhythmologie. Da diese Formen von Tachykardien häufig hämodynamisch bedeutsam sind, spielt dies für die Prävention des plötzlichen Herztodes eine zentrale Rolle. Sowohl in der Prävention der häufig zugrunde liegenden strukturellen Herzerkrankung als auch in der Therapie der Rhythmusstörungen haben sich in den letzten Jahren wichtige neue Aspekte ergeben. Die ICD Therapie hat sowohl im Hinblick auf die zur Verfügung stehenden Defibrillatoren als auch die Programmierung wesentliche Änderungen erfahren. Für die häufige einzig mögliche Therapie -die Katheterablation- stehen neue Bildgebungsverfahren zur Verfügung, die helfen, die Therapie zu optimieren. Auch das Verständnis der Mechanismen von VT sowie die Effektivität der Behandlung konnte mittels neuer Katheter- und Mappingtechnologien verbessert werden, so dass diese Therapie heute für mehr Patienten mit einer höheren Effektivität zur Verfügung steht.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Akhtar M, Elliott PM (2019) Risk stratification for sudden cardiac death in non-ischaemic dilated cardiomyopathy. Curr Cardiol Rep 21:155
Alzand BS, Crijns HJ (2011) Diagnostic criteria of broad QRS complex tachycardia: decades of evolution. Europace 13:465–472
Anderson KP (2005) Sudden cardiac death unresponsive to implantable defibrillator therapy: an urgent target for clinicians, industry and government. J Interv Card Electrophysiol 14:71–78
Anter E, Kleber AG, Rottmann M et al (2018) Infarct-related ventricular tachycardia: redefining the electrophysiological substrate of the isthmus during sinus rhythm. JACC Clin Electrophysiol 4:1033–1048
Anthony R, Daubert JP, Zareba W et al (2008) Mechanisms of ventricular fibrillation initiation in MADIT II patients with implantable cardioverter defibrillators. Pacing Clin Electrophysiol 31:144–150
Antzelevitch C, Shimizu W (2002) Cellular mechanisms underlying the long QT syndrome. Curr Opin Cardiol 17:43–51
Baba S, Dun W, Cabo C et al (2005) Remodeling in cells from different regions of the reentrant circuit during ventricular tachycardia. Circulation 112:2386–2396
Baman TS, Lange DC, Ilg KJ et al (2010) Relationship between burden of premature ventricular complexes and left ventricular function. Heart Rhythm 7:865–869
Bardy GH, Lee KL, Mark DB et al (2005) Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 352:225–237
Baser K, Bas HD, Yokokawa M et al (2014) Infrequent intraprocedural premature ventricular complexes: implications for ablation outcome. J Cardiovasc Electrophysiol 25:1088–1092
Bikkina M, Larson MG, Levy D (1992) Prognostic implications of asymptomatic ventricular arrhythmias: the Framingham Heart Study. Ann Intern Med 117:990–996
Brady WJ, Mattu A, Tabas J et al (2017) The differential diagnosis of wide QRS complex tachycardia. Am J Emerg Med 35:1525–1529
Brugada J, Katritsis DG, Arbelo E et al (2020) 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 41:655–720
Brugada P, Brugada J, Mont L et al (1991) A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex. Circulation 83:1649–1659
Busch S, Eckardt L, Sommer P et al (2019) Premature ventricular contractions and tachycardia in a structurally normal heart: idiopathic PVC and VT. Herzschrittmacherther Elektrophysiol 30:212–224
Buxton AE (2009) Risk stratification for sudden death in patients with coronary artery disease. Heart Rhythm 6:836–847
Cantillon DJ, Bianco C, Wazni OM et al (2012) Electrophysiologic characteristics and catheter ablation of ventricular tachyarrhythmias among patients with heart failure on ventricular assist device support. Heart Rhythm 9:859–864
Crijns HJ, Smeets JL, Rodriguez LM et al (1995) Cure of interfascicular reentrant ventricular tachycardia by ablation of the anterior fascicle of the left bundle branch. J Cardiovasc Electrophysiol 6:486–492
Cronin EM, Bogun FM, Maury P et al (2020) 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. J Arrhythm 36(1):1–58. https://doi.org/10.1002/joa3.12264
Daniels DV, Lu YY, Morton JB et al (2006) Idiopathic epicardial left ventricular tachycardia originating remote from the sinus of Valsalva: electrophysiological characteristics, catheter ablation, and identification from the 12-lead electrocardiogram. Circulation 113:1659–1666
De Bakker JM, Van Capelle FJ, Janse MJ et al (1988) Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation. Circulation 77:589–606
De Groot JR, Coronel R (2004) Acute ischemia-induced gap junctional uncoupling and arrhythmogenesis. Cardiovasc Res 62:323–334
Dinov B, Fiedler L, Schonbauer R et al (2014) Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study. Circulation 129:728–736
Dittrich S, Sultan A, Luker J et al (2021) Mapping strategies for premature ventricular contractions-activation, voltage, and/or pace map. Herzschrittmacherther Elektrophysiol 32:27–32
Eckardt L, Frommeyer G, Sommer P et al (2018) Updated survey on interventional electrophysiology: 5-year follow-up of infrastructure, procedures, and training positions in Germany. JACC Clin Electrophysiol 4:820–827
Eckart RE, Hruczkowski TW, Tedrow UB et al (2007) Sustained ventricular tachycardia associated with corrective valve surgery. Circulation 116:2005–2011
Gigli M, Merlo M, Graw SL et al (2019) Genetic risk of arrhythmic phenotypes in patients with dilated cardiomyopathy. J Am Coll Cardiol 74:1480–1490
Gorenek B, Kudaiberdieva G, Birdane A et al (2003) Initiation of monomorphic ventricular tachycardia: electrophysiological, clinical features, and drug therapy in patients with implantable defibrillators. J Electrocardiol 36:213–218
Haissaguerre M, Duchateau J, Dubois R et al (2020) Idiopathic ventricular fibrillation: role of Purkinje system and microstructural myocardial abnormalities. JACC Clin Electrophysiol 6:591–608
Haissaguerre M, Shah DC, Jais P et al (2002) Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation. Lancet 359:677–678
Jastrzebski M, Kukla P, Czarnecka D et al (2012) Comparison of five electrocardiographic methods for differentiation of wide QRS-complex tachycardias. Europace 14:1165–1171
Jong-Ming Pang B, Green MS (2017) Epidemiology of ventricular tachyarrhythmia: any changes in the past decades? Herzschrittmacherther Elektrophysiol 28:143–148
Kindwall KE et al (1988) Electrocardiographic criteria for ventricular tachycardia in wide complex left bundle branch block morphology tachycardias. Am J Cardiol 61(15):1279–1283. https://doi.org/10.1016/0002-9149(88)91169-1
Knops RE, Van Der Stuijt W, Smeding L (2021) Subcutaneous or transvenous defibrillator therapy. Reply. N Engl J Med 384:678–679
Kober L, Thune JJ, Nielsen JC et al (2016) Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med 375:1221–1230
Kuck KH, Schaumann A, Eckardt L et al (2010) Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial. Lancet 375:31–40
Kuck KH, Tilz RR, Deneke T et al. (2017) Impact of substrate modification by catheter ablation on implantable cardioverter-defibrillator interventions in patients with unstable ventricular arrhythmias and coronary artery disease: results from the multicenter randomized controlled sms (Substrate Modification Study). Circ Arrhythm Electrophysiol 10(3):e004422. https://doi.org/10.1161/CIRCEP.116.004422
Kumar S, Romero J, Mehta NK et al (2016) Long-term outcomes after catheter ablation of ventricular tachycardia in patients with and without structural heart disease. Heart Rhythm 13:1957–1963
Lamba J, Redfearn DP, Michael KA et al (2014) Radiofrequency catheter ablation for the treatment of idiopathic premature ventricular contractions originating from the right ventricular outflow tract: a systematic review and meta-analysis. Pacing Clin Electrophysiol 37:73–78
Lee GK, Klarich KW, Grogan M et al (2012) Premature ventricular contraction-induced cardiomyopathy: a treatable condition. Circ Arrhythm Electrophysiol 5:229–236
Ling Z, Liu Z, Su L et al (2014) Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol 7:237–243
Lo R, Chia KK, Hsia HH (2017) Ventricular tachycardia in ischemic heart disease. Card Electrophysiol Clin 9:25–46
Marchlinski Fe SD, Gottlieb C, Gonz'alez-Zuelgaray J, Dj C (1995) Electrical events associated with arrhythmia initiation and stimulation techniques for arrhythmia prevention. In: Zipes DP, Jaliffe J (Hrsg) Cardiac electrophysiology from cell to bedside, 2. Aufl., S 863–877
Moss AJ, Hall WJ, Cannom DS et al (1996) Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med 335:1933–1940
Moss AJ, Hall WJ, Cannom DS et al (2009) Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 361:1329–1338
Moss AJ, Schuger C, Beck CA et al (2012) Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med 367:2275–2283
Moss AJ, Zareba W, Hall WJ et al (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346:877–883
Passman R, Kadish A (2001) Polymorphic ventricular tachycardia, long Q-T syndrome, and torsades de pointes. Med Clin North Am 85:321–341
Pava LF, Perafan P, Badiel M et al (2010) R-wave peak time at DII: a new criterion for differentiating between wide complex QRS tachycardias. Heart Rhythm 7:922–926
Poole JE, Johnson GW, Hellkamp AS et al (2008) Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med 359:1009–1017
Priori SG, Blomstrom-Lundqvist C, Mazzanti A et al (2015) 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 36:2793–2867
Priori SG, Napolitano C, Tiso N et al (2001) Mutations in the cardiac ryanodine receptor gene (hRyR2) underlie catecholaminergic polymorphic ventricular tachycardia. Circulation 103:196–200
Reddy VY, Reynolds MR, Neuzil P et al (2007) Prophylactic catheter ablation for the prevention of defibrillator therapy. N Engl J Med 357:2657–2665
Sagawa T, Sagawa K, Kelly JE et al (2002) Activation of cardiac ryanodine receptors by cardiac glycosides. Am J Physiol Heart Circ Physiol 282:H1118–H1126
Sandler A, Marriot HJL (1965) The differential morphology of anomalous ventricular complexes of RBBB type in lead V1 – ventricular ectopy versus aberration. Circulation 31:551–556. https://doi.org/10.1161/01.cir.31.4.551
Sapp JL, Wells GA, Parkash R et al (2016) Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs. N Engl J Med 375:111–121
Schron EB, Exner DV, Yao Q et al (2002) Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation 105:589–594
Sedlacek K, Ruwald AC, Kutyifa V et al (2015) The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial. J Cardiovasc Electrophysiol 26:424–433
Simpson RJ Jr, Cascio WE, Schreiner PJ et al (2002) Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J 143:535–540
Sirichand S, Killu AM, Padmanabhan D et al (2017) Incidence of idiopathic ventricular arrhythmias: a population-based study. Circ Arrhythm Electrophysiol 10(2):e004662. https://doi.org/10.1161/CIRCEP.116.004662
Stec S, Sikorska A, Zaborska B et al (2012) Benign symptomatic premature ventricular complexes: short- and long-term efficacy of antiarrhythmic drugs and radiofrequency ablation. Kardiol Pol 70:351–358
Stiles MK, Fauchier L, Morillo CA et al (2019) 2019 HRS/EHRA/APHRS/LAHRS focused update to 2015 expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace 21:1442–1443
Sultan A, Luker J, Hoffmann B et al (2015) Necessity of epicardial ablation for ventricular tachycardia after sequential endocardial approach. Int J Cardiol 182:56–61
Tada H, Ito S, Naito S et al (2005) Idiopathic ventricular arrhythmia arising from the mitral annulus: a distinct subgroup of idiopathic ventricular arrhythmias. J Am Coll Cardiol 45:877–886
Vaseghi M, Hu TY, Tung R et al (2018) Outcomes of catheter ablation of ventricular tachycardia based on etiology in nonischemic heart disease: an international ventricular tachycardia ablation center collaborative study. JACC Clin Electrophysiol 4:1141–1150
Vereckei A, Duray G, Szenasi G et al (2007) Application of a new algorithm in the differential diagnosis of wide QRS complex tachycardia. Eur Heart J 28:589–600
Von Rotz M, Aeschbacher S, Bossard M et al (2017) Risk factors for premature ventricular contractions in young and healthy adults. Heart 103:702–707
Waks JW, Buxton AE (2018) Risk stratification for sudden cardiac death after myocardial infarction. Annu Rev Med 69:147–164
Wang PJ, Friedman PL (1989) „Clockwise“ and „counterclockwise“ bundle branch reentry as a mechanism for sustained ventricular tachycardia masquerading as supraventricular tachycardia. Pacing Clin Electrophysiol 12:1426–1432
Wellens HJ (2001) Electrophysiology: Ventricular tachycardia: diagnosis of broad QRS complex tachycardia. Heart 86:579–585
Wellens HJJ et al (1978) The value of the electrocardiogram in the differential diagnosis of a tachycardia with a widened QRS complex. Am J Med 64:27–33. https://doi.org/10.1016/0002-9343(78)90176-6
Wijnmaalen AP, Delgado V, Schalij MJ et al (2010) Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction. Heart 96:1275–1280
Wilkoff BL, Fauchier L, Stiles MK et al (2016) 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace 18:159–183
Willems S, Tilz RR, Steven D et al (2020) Preventive or deferred ablation of ventricular tachycardia in patients with ischemic cardiomyopathy and implantable defibrillator (BERLIN VT): A multicenter randomized trial. Circulation 141:1057–1067
Zaman S, Goldberger JJ, Kovoor P (2019) Sudden death risk-stratification in 2018-2019: the old and the new. Heart Lung Circ 28:57–64
Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M (2022) ESC Scientific Document Group. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 43(40):3997–4126. https://doi.org/10.1093/eurheartj/ehac262. PMID: 36017572
Zhong L, Lee YH, Huang XM et al (2014) Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study. Heart Rhythm 11:187–193
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this chapter
Cite this chapter
Steven, D., Scheurlen, C., Dittrich, S., Filipovic, K., van den Bruck, JH., Sultan, A. (2023). Ventrikuläre Herzrhythmusstörungen. In: Marx, N., Erdmann, E. (eds) Klinische Kardiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62932-1_4
Download citation
DOI: https://doi.org/10.1007/978-3-662-62932-1_4
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-62931-4
Online ISBN: 978-3-662-62932-1
eBook Packages: Medicine (German Language)