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Lopez EM, Malhotra R. Ventricular Tachycardia in Structural Heart Disease. J Innov Card Rhythm Manag. 2019;10(8):3762-3773doi: 10.19102/icrm.2019.100801.
Lopez, E. M., & Malhotra, R. (2019). Ventricular Tachycardia in Structural Heart Disease. The Journal of innovations in cardiac rhythm management, 10(8), 3762-3773. https://doi.org/10.19102/icrm.2019.100801
Lopez, Eliany Mejia, and Malhotra, Rohit. "Ventricular Tachycardia in Structural Heart Disease." The Journal of innovations in cardiac rhythm management vol. 10,8 (2019): 3762-3773. doi: https://doi.org/10.19102/icrm.2019.100801
Lopez EM, Malhotra R. Ventricular Tachycardia in Structural Heart Disease. J Innov Card Rhythm Manag. 2019 Aug 15;10(8):3762-3773. doi: 10.19102/icrm.2019.100801. eCollection 2019 Aug. PMID: 32477742; PMCID: PMC7252751.
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J Innov Card Rhythm Manag. 2019 Aug 15;10(8):3762-3773. doi: 10.19102/icrm.2019.100801. eCollection 2019 Aug.

Ventricular Tachycardia in Structural Heart Disease.

The Journal of innovations in cardiac rhythm management

Eliany Mejia Lopez, Rohit Malhotra

Affiliations

  1. Cardiac Electrophysiology Department, Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.

PMID: 32477742 PMCID: PMC7252751 DOI: 10.19102/icrm.2019.100801

Abstract

Patients with structural heart disease (SHD) are at risk of ventricular tachycardia (VT), which can be difficult to manage clinically. Many treatment options are currently available, but no single approach can be applied with 100% perfect results; often, a combination of therapies is required to achieve good control of ventricular arrhythmias. Coronary artery disease with previous myocardial infarction (MI) is the most common form of SHD presenting with VT, with scar-mediated reentry being the predominant mechanism. Other cardiomyopathies such as arrhythmogenic right ventricular cardiomyopathy, sarcoidosis, Chagas disease, and repaired congenital heart disease can also present in conjunction with ventricular arrhythmias. A thorough analysis of the patient's history, 12-lead electrocardiogram, and imaging findings are essential for understanding the mechanism and guiding localization of the site of origin of the arrhythmia and the presence of underlying heart disease, which will improve outcomes following catheter ablation if such is indicated. Separately, antiarrhythmic drugs have not been shown to decrease mortality in this patient population but can help to reduce the VT burden and subsequently the need for implantable cardioverter-defibrillator therapy. Unfortunately, most antiarrhythmic agents are negative inotropes, with the possibility of worsening heart failure. This review aims to discuss the current options available for the management of VT in SHD.

Copyright: © 2019 Innovations in Cardiac Rhythm Management.

Keywords: Ablation; mapping; ventricular tachycardia

Conflict of interest statement

The authors report no conflicts of interest for the published content.

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