[The best of arrhythmia in 2005].
In 2005, one of the major areas of interest in the field of electrophysiology remains ablation of atrial fibrillation (AF). Identification of specific atrial sites, likely playing a role in the perpetuation of this arrhythmia has taken part in the ablation technique refinement. An increase in the rate of asymptomatic AF following ablation has been reported this year, which underlined the need for long lasting ECG recordings to demonstrate ablation success. The role of ventricular programmed stimulation remained controversial in the management of Brugada syndrome. Nevertheless, in the report of the second consensus conference, result of ventricular programmed stimulation was still considered as important in the decision making process. The third form of short QT syndrome (SQT3) has been found to be caused by a mutation in the KCNJ2 gene, leading to an increase in the function of Ik1 channel. Right ventricular dilation seemed to be the most frequent echocardiography anomaly in patients with right ventricular dysplasia as defined by the criteria published in 1994. Ablation of frequent (>20% on Holter monitoring) ventricular premature beats has been shown to improve hemodynamics in patients with left ventricular dilation and impaired ejection fraction. Safety and efficacy of implantable cardioverter defibrillator (ICD) have been demonstrated in high risk patients with hypertrophic cardiomyopathy in a large clinical study. However, the use of high energy ICD and the systematic determination of the defibrillation threshold were recommended. Despite the presence of sophisticated algorithms to discriminate VT from SVT, high rates of inappropriate therapies were still reported in recent ICD studies.
Service de cardiologie, hôpital Charles Nicolle, 1, rue de Germont, 76000 Rouen. frederic.anselme@chu-rouen.fr
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D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D009202:Cardiomyopathies / Q000628:therapy; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006801:Humans; D011643:Publishing / Q000639:trends
D000889:Anti-Arrhythmia Agents