ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Contemporary Treatment Of The Arrhythmias
Dr. Kamil ADALETa
aKardiyoloji AD, İstanbul Üniversitesi Istanbul Tıp Fakültesi, İSTANBUL
The antiarrhytmic drugs are highly effective to terminate the supraventricular and ventricular tachycardias (VT), but it is not easy to say that same thing controlling tachyarrhythmias during the long term follow-up, and otherwise these drugs are not reliable for some form of supraventricular tachyarrhythmias and ventricular tachycardia in patients with organic heart disease. Radiofrequency catheter ablation is very effective and safe method to cure for nearly all kinds of tachyarrhythmias, and may be first treatment option in patients with atrial tachycardia, common atrial flutter, atrioventriculonodal reentrant tachycardia, atrioventricular reentrant tachycardia. Pulmonary vein isolation is the choice of ablation method to treat the symptomatic atrial fibrillation resistant to antiarrhythmic drugs, but it has still limited value to cure the many patients. Ablation may cure the most of patients with idiopathic VT. Catheter ablation is also highly effective, but recurrence rate of any VT following ablation procedure is high and may be life threatening in patients with organic heart disease, and implantable cardioverter defibrillator (ICD) implantation is the first treatment option. Catheter ablation may serve as an adjunctive therapy to ICD in patients with structural heart disease. ICD has also very important role for primary prevention of sudden cardiac death in high risk patients. New mapping (non-contact mapping-ENSITE-, three dimensional electroanatomic mapping ?CARTO-) and imaging (intracardiac echo, spiral CT, MR) techniques may increase the success rate of catheter ablation in patients with complex arrhythmias (scar related tachycardia, ischemic VT), and mapping may be possible to perform ablation previously considered as an unmappable tachyarrhythmias. Cardiac resynchronization therapy may improve quality of life, increase exercise capacity and ejection fraction, and even may increase survival in patients with congestive heart failure resistant to optimal medical therapy.Keywords: Ablation, antiarrhythmic drugs, arrhythmia,
cardiac resynchronization, implantable
cardioverter defibrillator, mappingTurkiye Klinikleri J Int Med Sci 2005, 1(15):88-109
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