Ventricular Arrhythmias: Epidemiology, Diagnosis and Treatment

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 4203

Special Issue Editors


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Guest Editor
1. Department of Cardiology, General Regional Hospital “F. Miulli”, 70021 Bari, Italy
2. Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
Interests: arrhythmias; catheter ablation; cardiac electrophysiology

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Guest Editor
Cardiology Department, Regional General Hospital “F. Miulli”, Acquaviva delle Fonti, 70021 Bari, Italy
Interests: arrhythmias; catheter ablation; cardiac electrophysiology; development of new technologies for catheter ablation of arrhythmias

Special Issue Information

Dear Colleagues,

Ventricular arrhythmias (VAs) occur most often in the context of structural heart disease, with a small group of patients presenting idiopathic VA without any structural abnormalities. Cardiac diseases associated with VA differ in young vs. older individuals. In the young, there is a predominance of channelopathies, cardiomyopathies, myocarditis and substance abuse, while in older populations, chronic degenerative diseases predominate (coronary artery disease, valvular heart diseases and heart failure). Refractory unstable ventricular arrhythmias and electrical storm are often life-threatening, increasing patients’ mortality rate up to 50%.

Pharmacological therapy often fails, necessitating catheter ablation with or without the implantation of a cardioverter-defibrillator. In particular, catheter ablation can reduce recurrent episodes of VA and improve patient prognoses; however, patients with hemodynamically unstable ventricular arrhythmias have a rate of procedural complications and mortality. Recent data suggest that mechanical circulatory support can provide valuable support during catheter ablation procedures to prevent peri-procedure adverse outcomes.

In recent years, new diagnostic and therapeutic techniques have been developed to improve the prognosis of patients suffering from VA. In particular, advanced imaging including computed tomography and magnetic resonance; new techniques to perform catheter ablation; and genetic testing can improve the management of VA.

The aim of the present Special Issue is to provide a clear and modern overview on the contemporary diagnosis and treatment of VA, with a focus on modern cardiac imaging techniques and catheter ablation procedures. By reading this Special Issue, cardiologists will improve their knowledge by learning about the latest trends in the diagnosis and treatment of VA.

Dr. Antonio Di Monaco
Prof. Dr. Massimo Grimaldi
Guest Editors

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Keywords

  • ventricular arrhythmias
  • electrical storm
  • Sudden cardiac death
  • cardiac imaging
  • catheter ablation
  • antiarrhythmic drugs
  • mechanical circulatory support

Published Papers (2 papers)

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16 pages, 841 KiB  
Review
Stereotactic Arrhythmia Radioablation Treatment of Ventricular Tachycardia: Current Technology and Evolving Indications
by Fabrizio Guarracini, Massimo Tritto, Antonio Di Monaco, Marco Valerio Mariani, Alessio Gasperetti, Paolo Compagnucci, Daniele Muser, Alberto Preda, Patrizio Mazzone, Sakis Themistoclakis and Corrado Carbucicchio
J. Cardiovasc. Dev. Dis. 2023, 10(4), 172; https://doi.org/10.3390/jcdd10040172 - 17 Apr 2023
Cited by 1 | Viewed by 2278
Abstract
Ventricular tachycardia in patients with structural heart disease is a significant cause of morbidity and mortality. According to current guidelines, cardioverter defibrillator implantation, antiarrhythmic drugs, and catheter ablation are established therapies in the management of ventricular arrhythmias but their efficacy is limited in [...] Read more.
Ventricular tachycardia in patients with structural heart disease is a significant cause of morbidity and mortality. According to current guidelines, cardioverter defibrillator implantation, antiarrhythmic drugs, and catheter ablation are established therapies in the management of ventricular arrhythmias but their efficacy is limited in some cases. Sustained ventricular tachycardia can be terminated by cardioverter-defibrillator therapies although shocks in particular have been demonstrated to increase mortality and worsen patients’ quality of life. Antiarrhythmic drugs have important side effects and relatively low efficacy, while catheter ablation, even if it is actually an established treatment, is an invasive procedure with intrinsic procedural risks and is frequently affected by patients’ hemodynamic instability. Stereotactic arrhythmia radioablation for ventricular arrhythmias was developed as bail-out therapy in patients unresponsive to traditional treatments. Radiotherapy has been mainly applied in the oncological field, but new current perspectives have developed in the field of ventricular arrhythmias. Stereotactic arrhythmia radioablation provides an alternative non-invasive and painless therapeutic strategy for the treatment of previously detected cardiac arrhythmic substrate by three-dimensional intracardiac mapping or different tools. Since preliminary experiences have been reported, several retrospective studies, registries, and case reports have been published in the literature. Although, for now, stereotactic arrhythmia radioablation is considered an alternative palliative treatment for patients with refractory ventricular tachycardia and no other therapeutic options, this research field is currently extremely promising. Full article
(This article belongs to the Special Issue Ventricular Arrhythmias: Epidemiology, Diagnosis and Treatment)
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13 pages, 2612 KiB  
Case Report
Solving the Riddle of Sudden Cardiac Death in Hypertrophic Cardiomyopathy: The Added Role of Cardiac Magnetic Resonance
by Kamil Stankowski, Stefano Figliozzi, Costanza Lisi, Federica Catapano, Cristina Panico, Francesco Cannata, Riccardo Mantovani, Antonio Frontera, Renato Maria Bragato, Giulio Stefanini, Lorenzo Monti, Gianluigi Condorelli and Marco Francone
J. Cardiovasc. Dev. Dis. 2023, 10(6), 226; https://doi.org/10.3390/jcdd10060226 - 23 May 2023
Cited by 1 | Viewed by 1425
Abstract
Cardiac magnetic resonance (CMR) has been recently implemented in clinical practice to refine the daunting task of establishing the risk of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). We present an exemplificative case highlighting the practical clinical utility of this [...] Read more.
Cardiac magnetic resonance (CMR) has been recently implemented in clinical practice to refine the daunting task of establishing the risk of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). We present an exemplificative case highlighting the practical clinical utility of this imaging modality in a 24-year-old man newly diagnosed with an apical HCM. CMR was essential in unmasking a high risk of SCD, which appeared low-intermediate after traditional risk assessment. A discussion examines the essential role of CMR in guiding the patient’s therapy and underlines the added value of CMR, including novel and potential CMR parameters, compared to traditional imaging assessment for SCD risk stratification. Full article
(This article belongs to the Special Issue Ventricular Arrhythmias: Epidemiology, Diagnosis and Treatment)
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