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Indications des ablations dans le traitement des arythmies cardiaques

Indications of catheter ablation in the treatment of cardiac arrhythmias

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Réanimation

Résumé

Les troubles du rythme cardiaque peuvent survenir sur un coeur apparemment sain ou compliquer une cardiopathie sous-jacente. Ils peuvent entraîner une gêne fonctionnelle parfois importante, une syncope, une insuffisance cardiaque, un accident thromboembolique ou une mort subite. Leur traitement associe médicaments antiarythmiques et/ou ablation, le choix dépendant de l’arythmie, du terrain, des avantages et risques de chaque stratégie et de la préférence du patient. L’ablation est la destruction de la structure responsable de l’arythmie, au moyen d’une source d’énergie, qui est le plus souvent la radiofréquence et dans certains cas la cryothérapie. Cette revue se propose de faire le point sur la place des techniques ablatives dans le traitement de la fibrillation atriale, du flutter atrial, de la réentrée intranodale, du syndrome de Wolff-Parkinson-White et des tachycardies ventriculaires.

Abstract

Cardiac arrhythmias can be primitive or associated with a variety of cardiovascular conditions. Arrhythmias may be responsible for an important alteration of quality of life, syncope, heart failure, thromboembolic events, or sudden death. Their treatment includes antiarrhythmic medications and/or ablation. The choice is influenced by the type of arrhythmia, medical history, benefits and risks of each strategy in an individual patient, and patient preference. Ablation is the destruction of the cardiac structure responsible for the arrhythmia by using a source of energy which is usually radiofrequency and in some cases cryotherapy. We review the indications of ablation techniques in the treatment of atrial fibrillation, atrial flutter, atrioventricular nodal reentry, Wolff-Parkinson-White syndrome, and ventricular tachycardia.

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Authors and Affiliations

  1. Département de rythmologie, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, F-75014, Paris, France

    G. Moubarak

  2. Service de cardiologie, CHU Lariboisière, F-75010, Paris, France

    G. Moubarak

  3. Service de cardiologie, CHU Charles-Nicolle, F-76000, Rouen, France

    F. Anselme

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  1. G. Moubarak
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  2. F. Anselme
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Correspondence to G. Moubarak.

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Moubarak, G., Anselme, F. Indications des ablations dans le traitement des arythmies cardiaques. Réanimation 24, 172–182 (2015). https://doi.org/10.1007/s13546-015-1040-z

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