☰ 目次
2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death
European Society of Cardiology・2022・130 ページ · 不整脈・デバイス・アブレーション · 予防・高血圧・脂質・糖尿病 · 集中治療・救急・蘇生
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2022 ESC Guidelines for the management of1 patients with ventricular arrhythmias and the prevention of sudden cardiac death1 Endorsed by the Association for European Paediatric and Congenital Cardiology (AEPC)1 Table of contents2 Tables of Recommendations4 List of tables5 List of figures5 Abbreviations and acronyms6 1 Preamble7 Class I Evide7 Class II7 Level of evidence A8 Level of evidence B8 Level of evidence C8 2 Introduction9 2.1 What is new9 2015 202214 3 Definitions15 3.1 Ventricular arrhythmia subtypes15 3.2 Sudden cardiac death15 3.3 Syncope15 3.4 Specialized centres15 3.5 Genetics15 4 Epidemiology of sudden cardiac15 death, public awareness, and risk stratification15 4.1 Incidence of sudden cardiac death15 4.2 Causes of sudden cardiac death in16 4.3 Population vs. individual risk16 4.4 Risk calculators for sudden cardiac16 4.5 Awareness and intervention: public16 10 20 30 40 50 60 70 8017 0 50 10017 5 Evaluation and treatment. General aspects18 5.1 Diagnostic tools18 5.2 Diagnostic evaluation at first22 LV fascicular VT (RBBB- like, superior axis, QRS 130 ms)24 RVOT VT (LBBB-like, inferior axis, V4 transition)24 ECG during BBR-VT ECG during sinus rhythm26 III26 aVR26 aVL26 aVF26 III26 aVR26 aVL26 aVF26 6 Therapies for ventricular31 arrhythmias. General aspects31 6.1 Acute management31 Repetitive runs of VT34 6.2 Long-term management38 7.1 Specific structural heart diseases48 ECG sinus rhythm – Small amplitude P waves and first degree AV block60 ECG VT – RBBB-like, inferior axis (LV summit origin)60 CMR – Mid-wall septal LGE60 4-chamber Short axis60 ECG sinus rhythm – Negative T wavesV1-V4, terminal QRS duration >55 ms63 ECG VT – LBBB-like, superior axis (basal RV origin)63 CMR – Dilated RV with basal aneurysm63 4-chamber 3-chamber Short axis63 ECG sinus rhythm – Negative T wavesV2-V6 and inferior leads65 ECG VT – RBBB-like, superior axis (apical LV origin)65 CMR – Apical aneurysm with LGE65 4-chamber 2-chamber65 ECG sinus rhythm – Prominent R’wave inV1-V3a73 ECG VT – LBBB-like, inferior axis (RVOT origin)73 CMR Basal LV and RV free wall LGE73 PET-CT Lateral and basal-septal LV increased 18FDG uptake73 7.2 Primary electrical disease77 Brugada type 1 pattern ECG A84 Early repolarization pattern ECG84 III84 1 Br87 Short QT syndrome91 8 Special aspects in selected92 populations92 8.1 Pregnant patients and peri-partum92 8.2 Heart transplantation93 8.3 Sudden cardiac death in athletes93 8.4 Wolff–Parkinson–White syndrome94 8.5 Prevention of sudden cardiac death94 9 Key messages94 9.1 General aspects94 9.2 Structural heart disease94 9.3 Primary electrical disease95 10 Gaps in evidence95 10.1 General aspects95 10.2 Structural heart disease—general95 10.3 Idiopathic premature ventricular95 complexes/ventricular tachycardia95 10.4 Coronary artery disease95 10.5 Cardiomyopathies95 10.6 Valvular heart disease95 10.7 Congenital heart disease95 10.8 Primary electrical disease95 11 ‘What to do’ and ‘what not to do’ messages from the Guidelines96 12 Quality indicators103 13 Supplementary data103 14 Data availability statement103 15 Author information103 16 Appendix104 17 References105
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