Ventricular arrhythmias in nonischemic cardiomyopathy

Fa Po Chung, Chin Yu Lin, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Yao Ting Chang, Ting Yung Chang, Chung-Hsing Lin, Abigail Louise D. Te, Shinya Yamada, Shih Ann Chen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Nonischemic cardiomyopathies (NICMs) are composed of variable disease entities, including primary and secondary cardiomyopathies. Determining the etiology of NICM provides pivotal roles of not only the understanding of the individual pathogenesis, but also the clinical management, such as risk stratification, pharmacological treatment, and intervention therapies. Despite the diverse causes of NICM, these cases mostly require clinical attention owing to progressive myocardial injury, resulting in ventricular dysfunction and heart failure. The interaction between the diseased ventricular substrates and systemic/neurophysiological factors contributes to the cornerstones responsible for ventricular arrhythmogenesis and sudden cardiac death (SCD). Prevention of SCD and diminishing ventricular tachyarrhythmias are the important mainstays for the management of NICM patients. Given the understanding of the abnormal ventricular substrates and advancement of navigation systems, radiofrequency catheter ablation (RFCA) has become an adjunctive or alternative strategy for NICM patients who experience drug-refractory ventricular tachycardias (VTs). Successful ablation can frequently be achieved at the expense of an epicardial intervention. A recent study has proven the survival benefits for NICM patients who are free from recurrent VTs after a successful RFCA, regardless of the New York Heart Association (NYHA) functional class status or left ventricular ejection fraction. Additionally, recent evidence has highlighted the better delineation of a diseased myocardium through the incorporation of cardiovascular magnetic resonance imaging (CMRI) and 3D mapping systems, which can facilitate the identification of critical ventricular arrhythmogenic substrates in NICM patients.

Original languageEnglish
Pages (from-to)336-346
Number of pages11
JournalJournal of Arrhythmia
Volume34
Issue number4
DOIs
Publication statusPublished - Aug 2018
Externally publishedYes

Keywords

  • Arrhythmogenic substrate
  • Cardiovascular magnetic resonance imaging
  • Catheter ablation
  • Implantable cardioverter-defibrillator
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Chung, F. P., Lin, C. Y., Lin, Y. J., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Chao, T. F., Liao, J. N., Chang, Y. T., Chang, T. Y., Lin, C-H., Te, A. L. D., Yamada, S., & Chen, S. A. (2018). Ventricular arrhythmias in nonischemic cardiomyopathy. Journal of Arrhythmia, 34(4), 336-346. https://doi.org/10.1002/joa3.12028