2015-04-01
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Чаще всего мы имеем дело с ЖТ из правого желудочка. У пациентов без структурных аномалий такая тахикардия не ухудшает прогноз жизни. Идиопатическая ЖТ из ЛЖ чаще всего исходит из волокон Пуркинье. Наиболее часто в лечении симптомных ЖНРС у больных с ГКМП используются БАБ или верапамил. Могут также использоваться ААП IC класса. Пациентам, у которых медикаментозная терапия оказалась неэффективной, показано проведение катетерной аблации аритмогенного очага. Учитывая низкий риск ВС, имплантация ИКД у таких пациентов показана только при затяжных пароксизмах ЖТ для скорейшего прерывая тахикардии.
В заключение нужно еще раз подчеркнуть, что антиаритмическое лечение – лишь надстройка над патогенетической терапией, которая должна проводиться всем больным с желудочковыми тахиаритмиями. Сбалансированный выбор тактики лечения позволит помочь пациенту даже в самых сложных случаях.
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