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Minerva Cardioangiologica 2007 June;55(3):341-51

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Post automatic implantable cardioverter defibrillator implant therapies: drugs and ablative techniques

Colella A. ¹, Pieragnoli P. ¹, Ricciardi G. ¹, Giaccardi M. ², Padeletti L. ¹, Michelucci A. ¹

¹ Department of Heart and Vessels University of Florence, Florence, Italy 2 Unit of Pediatric Cardiology Anna Meyer Hospital University of Florence, Florence, Italy

The aim of this article is to report the evidences about the use of drugs and ablation after implantation of a cardioverter defibrillator. Drugs can be utilized to prevent appropriate and inappropriate shocks, can influence positively or negatively defibrillation threshold, can be useful for the treatment of electrical storm. Ablation can be performed for direct cure of coexisting atrial and ventricular tachyarrhythmias or for AV node modulation. In particular, previous data demonstrate that rescue ventricular tachycardia ablation of drug-refractory electrical storm is possible by a substrate-orientated ablation approach even in patients with complex chronic infarction and various ventricular tachycardias. At the end of this article it is described how remote monitoring, a new very promising technical impro-vement, can be utilized for deciding, almost in real time, the use of both these therapies or for controlling their efficacy.