Interv Akut Kardiol. 2022;21(3):139-149 | DOI: 10.36290/kar.2022.019

Management of ventricular arrhythmias in heart failure: current perspectives

Adam Rafaj, Petr Peichl, Josef Kautzner

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

Congestive heart failure (HF) is a progressive disease defined as the inability of the heart to maintain adequate blood flow. Ventricular arrhythmias (VAs) are common in patients with HF. Moreover, an advanced HF increases the risk of VAs. The management of VAs in patients with HF requires a systematic, multimodal approach consisting of an optimized medical therapy, use of ICD and/or cardiac resynchronization therapy. Another possibility is catheter ablation (CA), which is the method of choice for arrhythmia-induced cardiomyopathy and may represent a life-saving procedure for patients with electric storm. Novel approaches in the treatment of refractory VAs include modulation of the autonomic nervous system and stereotactic radiotherapy. In patients with end-stage HF with VAs, implantation of mechanical cardiac support or heart transplantation can be considered. The purpose of this review is to provide an overview of strategies used for the treatment of VAs in patients with HF with an emphasis on interventional options.

Keywords: catheter ablation, implantable cardioverter­‑defibrillator, heart failure, sudden cardiac death, ventricular arrhythmia.

Received: June 7, 2022; Revised: June 7, 2022; Accepted: June 16, 2022; Prepublished online: June 16, 2022; Published: November 21, 2022  Show citation