A clinical approach to arrhythmias revisited in 2018 : From ECG over noninvasive
and invasive electrophysiology to advanced imaging
#MMPMID29450695
Jordaens L
Neth Heart J
2018[Apr]; 26
(4
): 182-189
PMID29450695
show ga
Understanding arrhythmias and their treatment is not always easy. The current
straightforward approach with catheter ablation and device therapy is an amazing
achievement, but does not make management of underlying or other cardiac disease
and pharmacological therapy unnecessary. The goal of this paper is to describe
how much of the knowledge of the 1980s and early 1990s can and should still be
applied in the modern treatment of patients with arrhythmias. After an
introduction, this review will focus on paroxysmal atrial fibrillation and
a prototype of 'idiopathic' ventricular arrhythmias, two diseases with a striking
similarity, and will discuss the arrhythmogenesis. The ECG continues to play an
important role in diagnostics. Both diseases are associated with a structurally
normal heart; the autonomic nervous system plays an important role in triggering
arrhythmias at both the atrial and ventricular level.