Work

Hybrid Therapy for Ventricular Arrhythmia Management

Year: 2000

Type: article

Abstract: Available treatment for the management of ventricular tachycardia (VT) includes antiarrhythmic drugs, implantable cardioverter defibrillators, and surgical or catheter ablation. Each therapy provides unique advantages in selected patients with life-threatening ventricular arrhythmias. Specifically, ablative therapy offers the only potential to cure VT. Implantable cardioverter defibrillator therapy, although not capable of preventing VT, was demonstrated convincingly by the Antiarrhythmias Versus Implantable Defibrillators (AVID) study to be more effective than antiarrhythmic drugs in reducing the risk of sudden cardiac death.30 Finally, only antiarrhythmic drugs provide noninvasive therapy that, although not curative, frequently can prevent symptomatic arrhythmia recurrences. Because the goal of arrhythmia management is not to provide the single best therapy but to provide the greatest assurance of symptomatic arrhythmia control, good quality of life, and increased survival, the use of combined or hybrid therapy has become an important treatment strategy for many patients with sustained ventricular arrhythmias in the setting of structural heart disease. This article focuses on the rationale for and benefits of hybrid therapy using the combination of catheter ablation and implantable defibrillators or antiarrhythmic drugs and implantable defibrillators. The use of such hybrid therapy is considered only for those patients who have structural heart disease in the form of ischemic or nonischemic cardiomyopathy. Potential pitfalls and important clinical considerations in using such hybrid therapy will be discussed.

Source: Cardiology Clinics

DOI: 10.1016/s0733-8651(05)70148-x