Recurrent ventricular arrhythmias (VAs) are a leading cause of cardiovascular morbidity and mortality. In the last three decades, important advancements have occurred in the understanding of the mechanisms of recurrent VAs, their prognostic implications in different clinical contexts, and their treatment options. VAs occur in structurally normal hearts as well as in patients with underlying heart disease, but the latter group has a particularly high risk of recurrent VAs. Catheter ablation offers the possibility of cure for a substantial proportion of patients. Research has focused on identifying optimal targets for ablation, correlating the underlying structural abnormalities with the site of origin of VAs, and determining the optimal procedural approach. Ablation therapy can be life-saving in select patients with high burden of repetitive VAs or advanced heart failure syndromes. This article focuses on clinical aspects of catheter ablation of VAs, particularly the selection and clinical management of patients undergoing catheter ablation procedures and expected outcomes.

中文翻译：

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难治性室性心律失常的消融治疗。

反复性室性心律失常（VAs）是心血管疾病发病率和死亡率的主要原因。在过去的三十年中，在了解复发性VA的机制，其在不同临床情况下的预后意义及其治疗选择方面取得了重要进展。VA发生在结构正常的心脏以及潜在心脏病患者中，但后者人群复发VA的风险特别高。导管消融为大部分患者提供了治愈的可能性。研究集中在确定最佳的消融目标，将潜在的结构异常与VAs的起源部位相关联，以及确定最佳的手术方法。消融疗法可以挽救重复性VA负荷高或晚期心力衰竭综合征的特定患者的生命。本文着重于VA导管消融的临床方面，尤其是接受导管消融程序和预期结果的患者的选择和临床管理。