FEATURES OF DIAGNOSTIC AND MEDICALLY INVASIVE MANAGEMENT OF FREQUENTLY RECURRENT POLYMORPHIC, POLYTOPIC VENTRICULAR TACHYCARDIA

Abstract

In today's conditions, given the difficult economic situation in the country and the low adherence of patients to treatment, a difficult and relevant issue is the treatment of post-myocardial infarction patients, especially in the complicated course of the disease. The main reason for the occurrence of complex cardiac arrhythmias is the formation of a focus of ectopic activity in the myocardium or the appearance of a re-entry wave. In case of recurrence of life-threatening tachycardias, despite antiarrhythmic therapy, the choice must be between escalating drug therapy and radiofrequency catheter ablation (RFA). Purpose: a detailed description of the clinical case of the disease in a patient with low compliance to medical treatment, who suffered an acute myocardial infarction and was subsequently hospitalized several times in a specialized cardiac hospital for the development of complex ventricular arrhythmias. The article describes in detail modern approaches to the diagnosis and treatment of life-threatening tachycardias, including emergency care, comparison of escalation of antiarrhythmic therapy with RFA in a patient with post-infarction cardiosclerosis and frequent attacks of recurrent polymorphic ventricular tachycardia, treatment of modern defibrillator, electrophysiological study, RFA. Conclusions: Long-term follow-up of a patient with low compliance to the treatment of complex ventricular arrhythmias showed that ablation of the ventricular tachycardia substrate was more effective than escalation of antiarrhythmic therapy, which led to the remodulation of the heart cavities, improving the quality of life of the patient and preventing the progression of cardiovascular events.

Keywords

• ventricular tachycardia, antiarrhythmic therapy, radiofrequency catheter ablation, remodulation of heart cavities.