ПОДХОДЫ К ВЕДЕНИЮ БОЛЬНЫХ С ВЫСОКИМ РИСКОМ ВНЕЗАПНОЙ СМЕРТИ С НАДЖЕЛУДОЧКОВЫМИ ТАХИАРИТМИЯМИ: ОБЗОР РЕКОМЕНДАЦИЙ

Группа пациентов с наличием суправентрикулярных тахикардий (СВТ) и высоким риском внезапной смерти объединяет больных с синдромом Вольфа-Паркинсона-Уайта (WPW), новорожденных с СВТ и пациентов с СВТ и выраженной структурной патологией сердца. Обзорная статья включает основные положения всех действующих в настоящий момент рекомендательных документов и экспертных консенсусов, касающихся подходов к профилактике внезапной сердечной смерти при различных видах СВТ у взрослых и детей. В обзоре описываются современные данные о риске внезапной сердечной смерти у пациентов, страдающих наджелудочковыми тахикардиями, возможные варианты патогенеза внезапной сердечной смерти у данной категории пациентов, действующей в настоящее время рекомендации по катетерной аблации суправентрикулярных тахикардий для профилактики внезапной сердечной смерти у взрослых и детей.

Наджелудочковая тахикардия , Суправентрикулярная тахикардия , Внезапная сердечная смерть , Катетерная аблация

1. Kantoch M.J. Supraventricular tachycardia in children. Indian J Pediatr. 2005; 72(7): 609-619.

2. Averill K.H., Lamb L.E. Electrocardiographic findings in 67,375 asymptomatic subjects. I. Incidence of abnormalities. Am J Cardiol. 1960; 6: 76-83.

3. Munger T.M., Packer D.L., Hammill S.C., Feldman B.J., Bailey K.R., Ballard D.J., Holmes D.R. Jr., Gersh B.J. A population study of the natural history of Wolff-ParkinsonWhite syndrome in Olmsted County, Minnesota, 1953-1989. Circulation.1993; 87: 866-873. doi: 10.1161/01.CIR.87.3.866.

4. Priori S.G., Blomström-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J., Elliott P.M., Fitzsimons D., Hatala R., Hindricks G., Kirchhof P., Kjeldsen K., Kuck K.H., Hernandez-Madrid A., Nikolaou N., Norekvål T.M., Spaulding C., Van Veldhuisen D.J. Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2015; 17(11): 16011687. doi: 10.1093/europace/euv319.

5. Haissaguerre M., Fischer B., Labbe T., Lemeґtayer P., Monserrat P., d’Ivernois C., Dartigues J.F., Warin J.F. Frequency of recurrent atrial fibrillation after catheter ablation of overt accessory pathways. Am J Cardiol. 1992; 69: 493-497.

6. Хоменко Е.А., Мамчур С.Е., Бохан Н.С., Романова М.П., Чичкова Т.Ю. Катетерная аблация при синдроме Вольфа-Паркинсона-Уайта на фоне фибрилляции предсердий. Комплексные проблемы сердечнососудистых заболеваний. 2017; 1: 15-19. doi: http://dx.doi.org/10.17802/2306-1278-2017-1-15-19.

7. Ammash N.M., Phillips S.D., Hodge D.O., Connolly H.M., Grogan M.A., Friedman P.A., Warnes C.A., Asirvatham S.J. Outcome of direct current cardioversion for atrial arrhythmias in adults with congenital heart disease. Int J Cardiol. 2012 Feb 9;154(3):270-274. doi: 10.1016/j.ijcard.2010.09.028.

8. Pappone C., Vicedomini G., Manguso F., Saviano M., Baldi M., Pappone A., Ciaccio C., Giannelli L., Ionescu B., Petretta A., Vitale R., Cuko A., Calovic Z., Fundaliotis A., Moscatiello M., Tavazzi L., Santinelli V. Wolff–Parkinson– White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014; 130: 811819. doi: 10.1161/CIRCULATIONAHA.114.011154.

9. Cohen M.I., Triedman J.K., Cannon B.C., Davis A.M., Drago F., Janousek J., Klein G.J., Law I.H., Morady F.J., Paul T., Perry J.C., Sanatani S., Tanel R.E. PACES/ HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff–Parkinson–White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS). Heart Rhythm. 2012; 9: 1006-1024.

10. Page R.L., Joglar J.A., Caldwell M.A., Calkins H., Conti J.B., Deal B.J., Estes N.A. 3rd, Field M.E., Goldberger Z.D., Hammill S.C., Indik J.H., Lindsay B.D., Olshansky B., Russo A.M., Shen W.K., Tracy C.M., Al-Khatib S.M. 2015 ACC/ AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2016; 67(13): e27-e115. doi: 10.1016/j. jacc.2015.08.856.

11. Belhassen B., Rogowski O., Glick A., Viskin S., Ilan M., Rosso R., Eldar M. Radiofrequency ablation of accessory pathways: a 14 year experience at the Tel Aviv Medical Center in 508 patients. Isr Med Assoc J. 2007; 9: 265-270.

12. Klein G.J., Prystowsky E.N., Yee R., Sharma A.D., Laupacis A. Asymptomatic Wolff-Parkinson-White. Should we intervene? Circulation. 1989; 80: 1902-1905.

13. Steinbeck G. Should radiofrequency current ablation be performed in asymptomatic patients with the Wolff-ParkinsonWhite syndrome? Pacing Clin Electrophysiol. 1993; 16(3 Pt 2): 649-652.

14. Spar D.S., Silver E.S., Hordof A.J., Liberman L. Relation of the utility of exercise testing for risk assessment in pediatric patients with ventricular preexcitation to pathway location. Am J Cardiol. 2012; 109: 1011-1014. doi: 10.1016/j.amjcard.2011.11.030.

15. Wackel P., Irving C., Webber S., Beerman L., Arora G. Risk stratification in Wolff-Parkinson-White syndrome: the correlation between noninvasive and invasive testing in pediatric patients. Pacing Clin Electrophysiol. 2012; 35: 14511457. doi: 10.1111/j.1540-8159.2012.03518.x.

16. Brembilla-Perrot B., Holban I., Houriez P., Claudon O., Beurrier D., Vançon .C. Influence of age on the potential risk of sudden death in asymptomatic Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2001; 24: 1514-1518.

17. Al-Khatib S.M., Arshad A., Balk E.M., Das S.R., Hsu J.C., Joglar J.A., Page R.L. Risk stratification for arrhythmic events in patients with asymptomatic pre-excitation: a systematic review for the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2016; 13: e222–e237. doi: 10.1016/j.hrthm.2015.09.017.

18. Клинические рекомендации по проведению электрофизиологических исследований, катетерной аблации и применению имплантируемых антиаритмических устройств. М.: ВНОА; 2017. 704 с.

19. Ju W., Yang B., Li M., Zhang F., Chen H., Gu K., Yu J., Cao K., Chen M. Tachycardiomyopathy complicated by focal atrial tachycardia: incidence, risk factors, and long-term outcome. J Cardiovasc Electrophysiol. 2014; 25(9): 953-957. doi: 10.1111/jce.12428.

20. Luber S., Brady W.J., Joyce T., Perron A.D. Paroxysmal supraventricular tachycardia: outcome after ED care. Am J Emerg Med. 2001; 19: 40-42.

21. Lim S.H., Anantharaman V., Teo W.S., Chan W.H. Slow infusion of calcium channel blockers compared with intravenous adenosine in the emergency treatment of supraventricular tachycardia. Resuscitation. 2009; 80: 523-528. doi: 10.1016/j.resuscitation.2009.01.017.

22. Roth A., Elkayam I., Shapira I., Sander J., Malov N., Kehati M., Golovner M. Effectiveness of prehospital synchronous direct-current cardioversion for supraventricular tachyarrhythmias causing unstable hemodynamic states. Am J Cardiol. 2003; 91: 489-491.

23. Stec S., Kryñski T., Kułakowski P. Efficacy of low energy rectilinear biphasic cardioversion for regular atrial tachyarrhythmias. Cardiol J. 2011; 18: 33-38.

24. Neumar R.W., Otto C.W., Link M.S., Kronick S.L., Shuster M., Callaway C.W., Kudenchuk P.J., Ornato J.P., McNally B., Silvers S.M., Passman R.S., White R.D., Hess E.P., Tang W., Davis D., Sinz E., Morrison L.J. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122 (18 Suppl 3): S729767. doi: 10.1161/CIRCULATIONAHA.110.970988.

25. Parker M.H., Sanoski C.A. Clinical Pearls in Using Antiarrhythmic Drugs in the Outpatient Setting. J Pharm Pract. 2016; 29(1): 77-86. doi: 10.1177/1933719115615878.

26. Higgins A.Y., Waks J.W., Josephson M.E. Influence of Gender on the Tolerability, Safety, and Efficacy of Quinidine Used for Treatment of Supraventricular and Ventricular Arrhythmias. Am J Cardiol. 2015; 116(12): 1845-1851. doi: 10.1016/j.amjcard.2015.09.042.

27. Scheinman M.M., Huang S. The 1998 NASPE prospective catheter ablation registry. Pacing Clin Electrophysiol. 2000; 23: 1020-1028.

28. Bohnen M., Stevenson W.G., Tedrow U.B., Michaud G.F., John R.M., Epstein L.M., Albert C.M., Koplan B.A. Incidence and predictors of major complications from contemporary catheter ablation to treat cardiac arrhythmias. Heart Rhythm. 2011; 8: 1661-1666. doi: 10.1016/j.hrthm.2011.05.017.

29. Ferrero de Loma-Osorio Á., Díaz-Infante E., Macías Gallego A. Spanish Catheter Ablation Registry Collaborators. Spanish Catheter Ablation Registry. 12th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2012). Rev Esp Cardiol (Engl Ed). 2013; 66: 983-992. doi: 10.1016/j.rec.2013.08.002.

30. Biviano A.B., Bain W., Whang W., Leitner J., Dizon J., Hickey K., Garan H. Focal left atrial tachycardias not associated with prior catheter ablation for atrial fibrillation: clinical and electrophysiological characteristics. Pacing Clin Electrophysiol. 2012; 35: 17-27. doi: 10.1111/j.1540-8159.2011.03227.x.

31. Spector P., Reynolds M.R., Calkins H., Sondhi M., Xu Y., Martin A., Williams C.J., Sledge I. Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. Am J Cardiol. 2009; 104: 671-677. doi: 10.1016/j.amjcard.2009.04.040.

32. Bastani H., Drca N., Insulander P., Schwieler J., Braunschweig F., Kennebäck G., Sadigh B., Tapanainen J., Jensen-Urstad M. Cryothermal vs. radiofrequency ablation as atrial flutter therapy: a randomized comparison. Europace. 2013; 15: 420-428. doi: 10.1093/europace/eus261.

33. Jaïs P., Shah D.C., Haïssaguerre M., Hocini M., Peng J.T., Takahashi A., Garrigue S., Le Métayer P., Clémenty J. Mapping and ablation of left atrial flutters. Circulation. 2000; 101: 2928-2934.

34. Delacretaz E., Ganz L.I., Soejima K., Friedman P.L., Walsh E.P., Triedman J.K., Sloss L.J., Landzberg M.J., Stevenson W.G. Multi atrial maco-re-entry circuits in adults with repaired congenital heart disease: entrainment mapping combined with three-dimensional electroanatomic mapping. J Am Coll Cardiol. 2001; 37: 1665-1676.

35. Da Costa A., Thévenin J., Roche F., Romeyer-Bouchard C., Abdellaoui L., Messier M., Denis L., Faure E., Gonthier R., Kruszynski G., Pages J.M., Bonijoly S., Lamaison D., Defaye P., Barthélemy J.C., Gouttard T., Isaaz K. Loire-Ardèche-DrômeIsère-Puy-de-Dôme Trial of Atrial Flutter Investigators. Results from the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter. Circulation. 2006; 114: 1676-1681. doi: 10.1161/CIRCULATIONAHA.106.638395.

36. Reithmann C., Hoffmann E., Spitzlberger G., Dorwarth U., Gerth A., Remp T., Steinbeck G. Catheter ablation of atrial flutter due to amiodarone therapy for paroxysmal atrial fibrillation. Eur Heart J. 2000; 21: 565-572.

37. Mohanty S., Mohanty P., Di Biase L., Bai R., Santangeli P., Casella M., Dello Russo A., Tondo C., Themistoclakis S., Raviele A., Rossillo A., Corrado A., Pelargonio G., Forleo G., Natale A. Results from a single-blind, randomized study comparing the impact of different ablation approaches on longterm procedure outcome in coexistent atrial fibrillation and flutter (APPROVAL). Circulation. 2013; 127: 1853-1860. doi: 10.1161/CIRCULATIONAHA.113.001855.

38. Wazni O., Marrouche N.F., Martin D.O., Gillinov A.M., Saliba W., Saad E., Klein A., Bhargava M., Bash D., Schweikert R., Erciyes D., Abdul-Karim A., Brachman J., Gunther J., Pisano E., Potenza D., Fanelli R., Natale A. Randomized study comparing combined pulmonary vein-left atrial junction disconnection and cavotricuspid isthmus ablation versus pulmonary vein-left atrial junction disconnection alone in patients presenting with typical atrial flutter and atrial fibrillation. Circulation. 2003; 108: 24792483. doi: 10.1161/01.CIR.0000101684.88679.AB

39. Coffey J.O., d'Avila A., Dukkipati S., Danik S.B., Gangireddy S.R., Koruth J.S., Miller M.A., Sager S.J., Eggert C.A., Reddy V.Y. Catheter ablation of scar-related atypical atrial flutter. Europace. 2013; 15: 414-419. doi: 10.1093/europace/eus312.

40. Mamchur S.E., Kurilin M.Y. High-amplitude pace mapping increases safety of radiofrequency catheter ablation of parahisian ectopic foci. Pacing Clin Electrophysiol. 2012; 35: 1458-1463. doi: 10.1111/j.1540-8159.2012.03515.x.

41. Fan R., Tardos J.G., Almasry I., Barbera S., Rashba E.J., Iwai S. Novel use of atrial overdrive pacing to rapidly differentiate junctional tachycardia from atrioventricular nodal reentrant tachycardia. Heart Rhythm. 2011; 8: 840-844. doi: 10.1016/j.hrthm.2011.01.011.

42. Khositseth A., Danielson G.K., Dearani J.A., Munger T.M., Porter C.J. Supraventricular tachyarrhythmias in Ebstein anomaly: management and outcome. J Thorac Cardiovasc Surg. 2004; 128: 826-833. doi: 10.1016/j.jtcvs.2004.02.012.

43. Bockeria L, Golukhova E, Dadasheva M, Revishvili A, Levant A, Bazaev V, Rzaev F, Kakuchaya T. Advantages and disadvantages of one-stage and two-stage surgery for arrhythmias and Ebstein's anomaly. Eur J Cardiothorac Surg. 2005; 28: 536-540. doi: 10.1016/j.ejcts.2005.04.047.

44. Scaglione M., Caponi D., Ebrille E., Di Donna P., Di Clemente F., Battaglia A., Raimondo C., Appendino M., Gaita F. Very long-term results of electroanatomic-guided radiofrequency ablation of atrial arrhythmias in patients with surgically corrected atrial septal defect. Europace. 2014; 1800-7.

45. Wu J., Deisenhofer I., Ammar S., et al. Acute and long-term outcome after catheter ablation of supraventricular tachycardia in patients after the Mustard or Senning operation for D-transposition of the great arteries. Europace. 2014; 16(12): 1800-1807. doi: 10.1093/europace/euu076.

46. Said S.M., Burkhart H.M., Schaff H.V., Cetta F., Driscoll D.J., Li Z., Oliver W.C. J.r, Ammash N.M., Dearani J.A. Fontan conversion: identifying the high-risk patient. Ann Thorac Surg. 2014; 97: 2115-2121. doi: 10.1016/j.athoracsur.2014.01.083.

47. Gutierrez S.D., Earing M.G., Singh A.K., Tweddell J.S., Bartz P.J. Atrial tachyarrhythmias and the Cox-maze procedure in congenital heart disease. Congenit Heart Dis. 2013; 8: 434439. doi: 10.1111/chd.12031.

48. Szumowski L., Szufladowicz E., Orczykowski M., Bodalski R., Derejko P., Przybylski A., Urbanek P., Kuśmierczyk M., Koźluk E., Sacher F., Sanders P., Dangel J., Haissaguerre M., Walczak F. Ablation of severe drug-resistant tachyarrhythmia during pregnancy. J Cardiovasc Electrophysiol. 2010; 21: 877882. doi: 10.1111/j.1540-8167.2010.01727.x.

49. Damilakis J., Theocharopoulos N., Perisinakis K., Manios E., Dimitriou P., Vardas P., Gourtsoyiannis N. Conceptus radiation dose and risk from cardiac catheter ablation procedures. Circulation. 2001; 104: 893-897.

50. Juneja R., Shah S., Naik N., Kothari S.S., Saxena A., Talwar K.K. Management of cardiomyopathy resulting from incessant supraventricular tachycardia in infants and children.Indian Heart J. 2002; 54: 176-180.

51. Koyak Z., Harris L., de Groot J.R., Silversides C.K., Oechslin E.N., Bouma B.J., Budts W., Zwinderman A.H., Van Gelder I.C., Mulder B.J.M. Sudden Cardiac Death in Adult Congenital Heart Disease. Circulation. 2012; 126: 1944-1954. doi: 10.1161/CIRCULATIONAHA.112.104786.

52. Kammeraad J.A.E., van Deurzen C.H.M., Sreeram N., Bink-Boelkens M.Th.E., Ottenkamp J., Helbing W.A. Predictors of Sudden Cardiac Death After Mustard or Senning Repair for Transposition of the Great Arteries. J Am Coll Cardiol 2004; 44: 1095-102. doi:10.1016/j.jacc.2004.05.073.

53. Sarkar D., Bull C., Yates R., Wright D., Cullen S., Gewillig M., Clayton R., Tunstill A., Deanfield J. Comparison of long-term outcomes of atrial repair of simple transposition with implications for late arterial switch strategy. Circulation. 1999; 100 (Suppl II): II-176–II-181.

54. Puley G., Siu S., Connelly M., Harrison D., Webb G., Williams W.G., Harris L. Arrhythmia and survival in patients 18 years after the Mustard procedure for complete transposition of the great arteries. Am J Cardiol. 1999; 83: 1080-1084.

55. Ruckdeschel E.S., Kay J., Varosy P., Nguyen D.T. Slow Pathway Modification in a Patient with D-Transposition of the Great Arteries and Atrial Switch Procedure. Card Electrophysiol Clin. 2016; 8(1): 191-196. doi: 10.1016/j.ccep.2015.10.027.

56. Cheung Y.F., Cheng Y.W., Chau K.T., Yung T.C., Tong K.S. Long-term outcome and cardiac arrhythmias in infants with right atrial isomerism. Zhonghua Er Ke Za Zhi. 2004; 42(3): 166-171.

57. Munclinger M.J., Thornton A.S., Schutte D.P., Sliwa K. Fatal potential of supraventricular tachycardia in hypertrophic cardiomyopathy. Int J Cardiol. 2004; 93(2-3): 335-337. doi : 10.1016/S0167-5273(03)00191-8.

58. Schimpf R., Giustetto C., Eckardt L., Veltmann C., Wolpert C., Gaita F., Breithardt G., Borggrefe M. Prevalence of supraventricular tachyarrhythmias in a cohort of 115 patients with Brugada syndrome. Ann Noninvasive Electrocardiol. 2008; 13(3): 266-269. doi: 10.1111/j.1542-474X.2008.00230.x.

59. Brugada J., Blom N., Sarquella-Brugada G., BlomstromLundqvist C., Deanfield J., Janousek J., Abrams D., Bauersfeld U., Brugada R., Drago F., de Groot N., Happonen J.M., Hebe J., Yen Ho S., Marijon E., Paul T., Pfammatter J.P., Rosenthal E. European Heart Rhythm Association; Association for European Paediatric and Congenital Cardiology. Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement. Europace. 2013; 15(9): 1337-1382. doi: 10.1093/europace/eut082.

60. Philip Saul J., Kanter R.J.; WRITING COMMITTEE, Abrams D., Asirvatham S., Bar-Cohen Y., Blaufox A.D., Cannon B., Clark J., Dick M., Freter A., Kertesz N.J., Kirsh J.A., Kugler J., LaPage M., McGowan F.X., Miyake C.Y., Nathan A., Papagiannis J., Paul T., Pflaumer A., Skanes A.C., Stevenson W.G., Von Bergen N., Zimmerman F. PACES/ HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease: Developed in partnership with the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American Academy of Pediatrics (AAP), the American Heart Association (AHA), and the Association for European Pediatric and Congenital Cardiology (AEPC). Heart Rhythm. 2016; 13(6): e251-289. doi: 10.1016/j.hrthm.2016.02.009.