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On antiarrhythmic therapy in a patient with dilated cardiomyopathy: a clinical case

DOI: https://doi.org/10.29296/25877305-2022-12-03

T. Sveklina, Candidate of Medical Sciences; A. Kuchmin, MD; E. Galova;
A. Kazachenko, Candidate of Medical Sciences; M. Tyuryupov; Ya. Reshetova
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia, Saint Petersburg

The paper gives modern ideas about the problem of ventricular arrhythmias in patients with dilated cardiomyopathy. It considers a clinical case that shows the complexity of managing patients with this profile. The authors also show the combined use of pharmacological and surgical treatments for frequent ventricular premature beats and persistent paroxysmal ventricular tachycardia. They also analyze and summarize current studies and clinical guidelines for the management of patients with arrhythmias refractory to the main classes of drugs.

dilated cardiomyopathy
ventricular arrhythmias
ventricular tachycardia

  1. Шляхто Е. В. Кардиология: национальное руководство. Под ред. Е.В. Шляхто. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2021; с. 558 [Shlyakhto E. V. Kardiologiya: natsional'noe rukovodstvo. Pod red. E.V. Shlyakhto. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2021; р. 558 (in Russ.)].
  2. Терещенко С.Н., Алаева Е.Н., Нарусов О.Ю и др. Распространенность и диагностика дилатационной кардиомиопатии по данным Российского регистра. Кардиология. 2012; 52 (7): 67–72 [Tereshchenko S.N., Alaeva E.N., Narusov O.Y. et al. Prevalence and diagnosis of dilated cardiomyopathy according to Russian register. Kardiologiia. 2012; 52 (7): 67–72 (in Russ.)].
  3. Van Berlo J.H., De Voogt W.G., Van Der Kooi A.J. et al. Meta-analysis of clinical characteristics of 299 carriers of LMNA gene mutations: do lamin A/C mutations portend a high risk of sudden death. J Mol Med. 2005; 83 (1): 79–83. DOI: 10.1007/s00109-004-0589-1
  4. Soejima K., Stevenson W. G., Sapp J. L. et al. Endocardial and epicardial radiofrequency ablation of ventricular tachycardia associated with dilated cardiomyopathy: the importance of low-voltage scars. J Am Coll Cardiol. 2004; 43 (10): 1834–42. DOI: 10.1016/j.jacc.2004.01.029
  5. Hsia H.H., Callans D.J., Marchlinski F.E. Characterization of endocardial electrophysiological substrate in patients with nonischemic cardiomyopathy and monomorphic ventricular tachycardia. Circulation. 2003; 108 (6): 704–10. DOI: 10.1161/01.CIR.0000083725.72693.EA
  6. Лебедев Д.С. Михайлов Е.Н., Неминущий Н.М. и др. Желудочковые нарушения ритма. Желудочковые тахикардии и внезапная сердечная смерть. Клинические рекомендации 2020. Российский кардиологический журнал. 2021; 26 (7): 4600 [Lebedev D.S., Mikhailov E.N., Neminuschiy N.M. et al. Ventricular arrhythmias. Ventricular tachycardias and sudden cardiac death. 2020 Clinical guidelines. Russian Journal of Cardiology. 2021; 26 (7): 4600 (in Russ.)]. DOI: 10.15829/1560-4071-2021-4600
  7. Piers S.R., Leong D.P., van Huls van Taxis C.F. et al. Outcome of ventricular tachycardia ablation in patients with nonischemic cardiomyopathy: the impact of noninducibility. Circ Arrhythm Electrophysiol. 2013; 6 (3): 513–21. DOI: 10.1161/CIRCEP.113.000089
  8. Dinov B., Fiedler L., Schönbauer R. et al. 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. 2014; 129 (7): 728–36. DOI: 10.1161/CIRCULATIONAHA.113.003063
  9. Cano O., Hutchinson M., Lin D. et al. Electroanatomic substrate and ablation outcome for suspected epicardial ventricular tachycardia in left ventricular nonischemic cardiomyopathy. J Am Coll Cardiol. 2010; 56 (23): 1964. DOI: 10.1016/j.jacc.2009.05.032
  10. Nakahara S., Tung R., Ramirez R.J. et al. Characterization of the arrhythmogenic substrate in ischemic and nonischemic cardiomyopathy implications for catheter ablation of hemodynamically unstable ventricular tachycardia. J Am Coll Cardiol. 2010; 55 (21): 2355–65. DOI: 10.1016/j.jacc.2010.01.041
  11. Blaauw Y., Pison L., van Opstal J.M. et al. Reversal of ventricular premature beat induced cardiomyopathy by radiofrequency catheter ablation. Neth Heart J. 2010; 18 (10): 493–8. DOI: 10.1007/BF03091821
  12. Al-Khatib S.M., Stevenson W.G., Ackerman M.J. et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2018; 138 (13): 272–391. DOI: 10.1161/CIR.0000000000000549
  13. McDonagh T.A., Metra M., Adamo M. et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022; 24 (1): 4–131. DOI: 10.1002/ejhf.2333
  14. Muser D., Santangeli P., Castro S.A. et al. Long-Term Outcome After Catheter Ablation of Ventricular Tachycardia in Patients With Nonischemic Dilated Cardiomyopathy. Circ Arrhythm Electrophysiol. 2016; 9 (10): 004328. DOI:10.1161/CIRCEP.116.004328