Aritmilerde İleri Tedaviler: Elektrofizyolojik Çalışma (EPS) ve Kalıcı Kalp Pili
Özet
Aritmilerin ileri tedavileri arasında elektrofizyolojik çalışma (EPS) ve kalıcı kalp pili prosedürleri önemli bir konumdadır. EPS, aritmilerin teşhis ve tedavisinde kullanılan bir yöntem olup, kalbin elektriksel aktivitesini ölçerek aritmik odakların saptanmasını hedeflemektedir. EPS sonuçlarına dayanarak, katater ablasyon ve/veya kalıcı kalp pili implantasyonu gerekebilir. Kalıcı kalp pili, düzenli kardiyak ritmin sağlanmasını amaçlayan bir cihazdır. Pil elektrotları, kalp kasına bağlanarak normal ritmi sürdürmek üzere düzenli elektriksel uyarıları iletmektedir. Bu gelişmiş tedavi yöntemleri, aritmilerin tanısı ve yönetiminde kritik bir rol oynamakta olup son yıllarda malign aritmilere yönelik acil tedavi seçenekleri arasında da önemli bir yer edinmektedir.
Referanslar
Rosen MR, Hordof AJ, Hodess AB, Verosky M, Vulliemoz Y. Ouabain-induced changes in electrophysiologic properties of neonatal, young and adult canine cardiac Purkinje Fibers. Journal of Pharmacology and Experimental Therapeutics. 1975;194(1):255-63.
Scherlag BJ, Lau SH, Helfant RH, BERKOWITZ WD, Stein E, Damato AN. Catheter technique for recording His bundle activity in man. Circulation. 1969;39(1):13-8.
Denniss AR, Ross DL, Richards DA, Uther JB. Electrophysiologic studies in patients with unexplained syncope. International journal of cardiology. 1992;35(2):211-7.
Rodriguez RD, Schocken DD. Update on sick sinus syndrome, a cardiac disorder of aging. Geriatrics (Basel, Switzerland). 1990;45(1):26-30, 3.
Jensen PN, Gronroos NN, Chen LY, Folsom AR, Defilippi C, Heckbert SR, et al. Incidence of and risk factors for sick sinus syndrome in the general population. Journal of the American College of Cardiology. 2014;64(6):531-8.
Brignole M, Moya A, de Lange FJ, Deharo J-C, Elliott PM, Fanciulli A, et al. Practical Instructions for the 2018 ESC Guidelines for the diagnosis and management of syncope. European heart journal. 2018;39(21):e43-e80.
Brignole M, Moya A, de Lange FJ, Deharo J-C, Elliott PM, Fanciulli A, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. European heart journal. 2018;39(21):1883-948.
Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). European heart journal. 2021;42(35):3427-520.
Fujimura O, Yee R, Klein GJ, Sharma AD, Boahene KA. The diagnostic sensitivity of electrophysiologic testing in patients with syncope caused by transient bradycardia. New England Journal of Medicine. 1989;321(25):1703-7.
Lilly LS, Braunwald E. Braunwald's heart disease: a textbook of cardiovascular medicine: Elsevier Health Sciences; 2012.
KAUL U, DEV V, NARULA J, MALHOTRA AK, TALWAR KK, BHATIA ML. Evaluation of patients with bundle branch block and “unexplained” syncope: a study based on comprehensive electrophysiologic testing and ajmaline stress. Pacing and Clinical Electrophysiology. 1988;11(3):289-97.
Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). European heart journal. 2019;41(5):655-720.
Lip GY, Coca A, Kahan T, Boriani G, Manolis AS, Olsen MH, et al. Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-pacific heart rhythm society (APHRS) and sociedad latinoamericana de estimulacion Cardiaca y electrofisiologia (SOLEACE). Ep Europace. 2017;19(6):891-911.
Kubuš P, Vít P, Gebauer RA, Materna O, Janoušek J. Electrophysiologic profile and results of invasive risk stratification in asymptomatic children and adolescents with the Wolff–Parkinson–White electrocardiographic pattern. Circulation: Arrhythmia and Electrophysiology. 2014;7(2):218-23.
Pappone C, Santinelli V, Manguso F, Augello G, Santinelli O, Vicedomini G, et al. A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff–Parkinson–White syndrome. New England Journal of Medicine. 2003;349(19):1803-11.
Alzand BS, Crijns HJ. Diagnostic criteria of broad QRS complex tachycardia: decades of evolution. Europace. 2011;13(4):465-72.
Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Developed by the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) Endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC). European heart journal. 2022;43(40):3997-4126.
Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY, et al. Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. Pacing and Clinical Electrophysiology. 2001;24(11):1623-30.
Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A, et al. Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. Journal of the American College of Cardiology. 2001;37(7):1901-7.
Orvin K, Eisen A, Goldenberg I, Gottlieb S, Kornowski R, Matetzky S, et al. Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias. EP Europace. 2016;18(2):219-26.
Hoffmayer KS, Bhave PD, Marcus GM, James CA, Tichnell C, Chopra N, et al. An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia. Heart Rhythm. 2013;10(4):477-82.
Baman TS, Lange DC, Ilg KJ, Gupta SK, Liu T-Y, Alguire C, et al. Relationship between burden of premature ventricular complexes and left ventricular function. Heart rhythm. 2010;7(7):865-9.
van Huls van Taxis CF, Piers SR, de Riva Silva M, Dekkers OM, Pijnappels DA, Schalij MJ, et al. Fatigue as presenting symptom and a high burden of premature ventricular contractions are independently associated with increased ventricular wall stress in patients with normal left ventricular function. Circulation: Arrhythmia and Electrophysiology. 2015;8(6):1452-9.
Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). EP Europace. 2022;24(1):71-164.
Members WC, Epstein AE, DiMarco JP, Ellenbogen KA, Estes III NM, Freedman RA, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008;117(21):e350-e408.
Mangrum JM, DiMarco JP. The evaluation and management of bradycardia. New England Journal of Medicine. 2000;342(10):703-9.
Jiang Z, Mangharam R, editors. Modeling cardiac pacemaker malfunctions with the virtual heart model. 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2011: IEEE.
Tang AS, Wells GA, Talajic M, Arnold MO, Sheldon R, Connolly S, et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. New England Journal of Medicine. 2010;363(25):2385-95.
Cleland JG, Daubert J-C, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. New England Journal of Medicine. 2005;352(15):1539-49.
Groh WJ, Silka MJ, Oliver RP, Halperin BD, McAnulty JH, Kron J. Use of implantable cardioverter-defibrillators in the congenital long QT syndrome. American Journal of Cardiology. 1996;78(6):703-6.
Saksena S, From TPIG. Clinical outcome of patients with malignant ventricular tachyarrhythmias and a multiprogrammable implantable cardioverter-defibrillator implanted with or without thoracotomy: an international multicenter study. Journal of the American College of Cardiology. 1994;23(7):1521-30.
KAYNAKLAR
Lei M, Wu L, Terrar DA, Huang CL-H. Modernized classification of cardiac antiarrhythmic drugs. Circulation 2018;138:1879-1896.
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology 2018;72:e91-e220.
Members ATF, Priori SG, Blomström-Lundqvist C, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Ep Europace 2015;17:1601-1687.
Deyell MW, AbdelWahab A, Angaran P, Essebag V, Glover B, Gula LJ, Khoo C, Lane C, Nault I, Nery PB. 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Position Statement on the management of ventricular tachycardia and fibrillation in patients with structural heart disease. Canadian Journal of Cardiology 2020;36:822-836.
Huang CLH, Wu L, Jeevaratnam K, Lei M. Update on antiarrhythmic drug pharmacology. Journal of Cardiovascular Electrophysiology 2020;31:579-592.
Karcıoğlu Ö, Serinken M. Acil Kardiyak Girişimler: Defibrilasyon, kardiyoversiyon, transkütan pil uygulamaları. Satar S, Karcıoğlu Ö. Kardiyak Aciller. 1. Baskı, Nobel Kitabevi, Adana, 2007. sf. 43-56.
Panchal AR, Berg KM, Hirsch KG, et al. 2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support: Use of Advanced Airways, Vasopressors, and Extracorporeal Cardiopulmonary Resuscitation During Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. November 2019. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000732
2018 American Heart Association Focused Update on Advanced Cardiovascular Life Support Use of Antiarrhythmic Drugs During and Immediately After Cardiac Arrest. Circulation. 2018;138:e740–e749. DOI: 10.1161/CIR.0000000000000613
Referanslar
Rosen MR, Hordof AJ, Hodess AB, Verosky M, Vulliemoz Y. Ouabain-induced changes in electrophysiologic properties of neonatal, young and adult canine cardiac Purkinje Fibers. Journal of Pharmacology and Experimental Therapeutics. 1975;194(1):255-63.
Scherlag BJ, Lau SH, Helfant RH, BERKOWITZ WD, Stein E, Damato AN. Catheter technique for recording His bundle activity in man. Circulation. 1969;39(1):13-8.
Denniss AR, Ross DL, Richards DA, Uther JB. Electrophysiologic studies in patients with unexplained syncope. International journal of cardiology. 1992;35(2):211-7.
Rodriguez RD, Schocken DD. Update on sick sinus syndrome, a cardiac disorder of aging. Geriatrics (Basel, Switzerland). 1990;45(1):26-30, 3.
Jensen PN, Gronroos NN, Chen LY, Folsom AR, Defilippi C, Heckbert SR, et al. Incidence of and risk factors for sick sinus syndrome in the general population. Journal of the American College of Cardiology. 2014;64(6):531-8.
Brignole M, Moya A, de Lange FJ, Deharo J-C, Elliott PM, Fanciulli A, et al. Practical Instructions for the 2018 ESC Guidelines for the diagnosis and management of syncope. European heart journal. 2018;39(21):e43-e80.
Brignole M, Moya A, de Lange FJ, Deharo J-C, Elliott PM, Fanciulli A, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. European heart journal. 2018;39(21):1883-948.
Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). European heart journal. 2021;42(35):3427-520.
Fujimura O, Yee R, Klein GJ, Sharma AD, Boahene KA. The diagnostic sensitivity of electrophysiologic testing in patients with syncope caused by transient bradycardia. New England Journal of Medicine. 1989;321(25):1703-7.
Lilly LS, Braunwald E. Braunwald's heart disease: a textbook of cardiovascular medicine: Elsevier Health Sciences; 2012.
KAUL U, DEV V, NARULA J, MALHOTRA AK, TALWAR KK, BHATIA ML. Evaluation of patients with bundle branch block and “unexplained” syncope: a study based on comprehensive electrophysiologic testing and ajmaline stress. Pacing and Clinical Electrophysiology. 1988;11(3):289-97.
Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). European heart journal. 2019;41(5):655-720.
Lip GY, Coca A, Kahan T, Boriani G, Manolis AS, Olsen MH, et al. Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-pacific heart rhythm society (APHRS) and sociedad latinoamericana de estimulacion Cardiaca y electrofisiologia (SOLEACE). Ep Europace. 2017;19(6):891-911.
Kubuš P, Vít P, Gebauer RA, Materna O, Janoušek J. Electrophysiologic profile and results of invasive risk stratification in asymptomatic children and adolescents with the Wolff–Parkinson–White electrocardiographic pattern. Circulation: Arrhythmia and Electrophysiology. 2014;7(2):218-23.
Pappone C, Santinelli V, Manguso F, Augello G, Santinelli O, Vicedomini G, et al. A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff–Parkinson–White syndrome. New England Journal of Medicine. 2003;349(19):1803-11.
Alzand BS, Crijns HJ. Diagnostic criteria of broad QRS complex tachycardia: decades of evolution. Europace. 2011;13(4):465-72.
Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: Developed by the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) Endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC). European heart journal. 2022;43(40):3997-4126.
Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY, et al. Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. Pacing and Clinical Electrophysiology. 2001;24(11):1623-30.
Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A, et al. Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. Journal of the American College of Cardiology. 2001;37(7):1901-7.
Orvin K, Eisen A, Goldenberg I, Gottlieb S, Kornowski R, Matetzky S, et al. Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias. EP Europace. 2016;18(2):219-26.
Hoffmayer KS, Bhave PD, Marcus GM, James CA, Tichnell C, Chopra N, et al. An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia. Heart Rhythm. 2013;10(4):477-82.
Baman TS, Lange DC, Ilg KJ, Gupta SK, Liu T-Y, Alguire C, et al. Relationship between burden of premature ventricular complexes and left ventricular function. Heart rhythm. 2010;7(7):865-9.
van Huls van Taxis CF, Piers SR, de Riva Silva M, Dekkers OM, Pijnappels DA, Schalij MJ, et al. Fatigue as presenting symptom and a high burden of premature ventricular contractions are independently associated with increased ventricular wall stress in patients with normal left ventricular function. Circulation: Arrhythmia and Electrophysiology. 2015;8(6):1452-9.
Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). EP Europace. 2022;24(1):71-164.
Members WC, Epstein AE, DiMarco JP, Ellenbogen KA, Estes III NM, Freedman RA, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008;117(21):e350-e408.
Mangrum JM, DiMarco JP. The evaluation and management of bradycardia. New England Journal of Medicine. 2000;342(10):703-9.
Jiang Z, Mangharam R, editors. Modeling cardiac pacemaker malfunctions with the virtual heart model. 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2011: IEEE.
Tang AS, Wells GA, Talajic M, Arnold MO, Sheldon R, Connolly S, et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. New England Journal of Medicine. 2010;363(25):2385-95.
Cleland JG, Daubert J-C, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. New England Journal of Medicine. 2005;352(15):1539-49.
Groh WJ, Silka MJ, Oliver RP, Halperin BD, McAnulty JH, Kron J. Use of implantable cardioverter-defibrillators in the congenital long QT syndrome. American Journal of Cardiology. 1996;78(6):703-6.
Saksena S, From TPIG. Clinical outcome of patients with malignant ventricular tachyarrhythmias and a multiprogrammable implantable cardioverter-defibrillator implanted with or without thoracotomy: an international multicenter study. Journal of the American College of Cardiology. 1994;23(7):1521-30.
KAYNAKLAR
Lei M, Wu L, Terrar DA, Huang CL-H. Modernized classification of cardiac antiarrhythmic drugs. Circulation 2018;138:1879-1896.
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology 2018;72:e91-e220.
Members ATF, Priori SG, Blomström-Lundqvist C, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Ep Europace 2015;17:1601-1687.
Deyell MW, AbdelWahab A, Angaran P, Essebag V, Glover B, Gula LJ, Khoo C, Lane C, Nault I, Nery PB. 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Position Statement on the management of ventricular tachycardia and fibrillation in patients with structural heart disease. Canadian Journal of Cardiology 2020;36:822-836.
Huang CLH, Wu L, Jeevaratnam K, Lei M. Update on antiarrhythmic drug pharmacology. Journal of Cardiovascular Electrophysiology 2020;31:579-592.
Karcıoğlu Ö, Serinken M. Acil Kardiyak Girişimler: Defibrilasyon, kardiyoversiyon, transkütan pil uygulamaları. Satar S, Karcıoğlu Ö. Kardiyak Aciller. 1. Baskı, Nobel Kitabevi, Adana, 2007. sf. 43-56.
Panchal AR, Berg KM, Hirsch KG, et al. 2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support: Use of Advanced Airways, Vasopressors, and Extracorporeal Cardiopulmonary Resuscitation During Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. November 2019. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000732
2018 American Heart Association Focused Update on Advanced Cardiovascular Life Support Use of Antiarrhythmic Drugs During and Immediately After Cardiac Arrest. Circulation. 2018;138:e740–e749. DOI: 10.1161/CIR.0000000000000613
