Ventricular Arrhythmias

My ESC in Marocco

JC Deharo, MD, FESC

Relationship disclosure

• Research Grants: Biotronik; Boston Scientific; Medtronic; Saint Jude Medical; Sorin

Group;

• Honoraria / Travel Grants for Lectures: Biotronik; Boston Scientific; Medtronic; Saint Jude Medical; Sorin

Group; Spectranetics; Boehringer Ingelheim; Sanofi; MedaPharma; Bayer

• Consultant :Medtronic; Spectranetics

LVEF ≤ 35%NYHA II – III

OMT > 3 mo.

Ischemic CMNon ischemic

CM

Primary prevention by the ICD

I I

DINAMIT trial, Hohnloser NEJM 2004

1 - Reperfusion

2 – Bêta bloquants & Amiodarone ±

Lidocaine

3 – Rééquilibration hydro-électrolytique

Lidocaine

4 – Ablation

Catheter ablation

Substrate

Voltage map / Abnormal potentials

Non reproductible

Unstable

Poorly tolerated

General anesthesia

Hemodynamic support

VT Induction attempt

Poorly toleratedVF / VT (> 48H after

MI)

Well tolerated VT(> 48H after MI

VentricularArrhythmia

I IIa

Secondary prevention by the ICD

Fata

l e

ve

nts