Professional Documents
Culture Documents
Arrhythmia in heart failure
Arrhythmia in heart failure
0.5
0.4
0.3
0.2
0.1
0
e Rx II AT II ite I D d a ME us
Pr lv T ST IS El AV on sic
TI s
VD So eF F C IB am G e P se
n
L V-
H
CH Di O n
SO Co
th
McMurray JJV, et al. European Heart Journal (2012) 33, 1787–1847 4
McMurray JJV, et al. European Heart Journal (2012) 33, 1787–1847
Extreme case
AV node ablation and pacing may be required
CRT may be considered instead of conventional pacing
th
4
Treatment
Most patients with systolic HF will have a risk score consistent with a firm
indication for (score≥2) or preference for an oral anticoagulant (score=1)
although
bleeding risk must also be considered
Tedrow U and Stevenson WG. Management of Atrial and Ventricular Arrhythmias in Heart Failure. Marcel Dekker New York. 2005
Monomorphic Ventricular Tachycardia
Ischemic
Mechanisme of VT
Patients with Ischemic Cardiomyopathy typically have large areas of
infarction. Surviving myocyte bundles present within the infarction
create channels for conduction set up reentry circuits VT
Tedrow U and Stevenson WG. Management of Atrial and Ventricular Arrhythmias in Heart Failure. Marcel Dekker New York. 2005
Monomorphic Ventricular Tachycardia
non ischemic
Mechanisme of VT
Patients with non Ischemic Cardiomyopathy who develop sustained
monomorphic VT, most have evidence of large areas of
ventricular scar associated with a reentry circuit
Mechanisme of VT
Electrophysiological changes that accompany ventricular hypertrophy in
chronic heart failure may increase susceptibility to torsades de pointes