Radiofrequency catheter ablation (RFCA) has become an important treatment option in the management of supraventricular arrhythmias such as atrioventricular (nodal) re-entry tachycardia, atrial... Show moreRadiofrequency catheter ablation (RFCA) has become an important treatment option in the management of supraventricular arrhythmias such as atrioventricular (nodal) re-entry tachycardia, atrial tachycardia, atrial flutter and atrial fibrillation (AF). Particularly in the management of AF the number of RFCA procedures performed is growing rapidly. Three-dimensional electroanatomical mapping combined with non-invasive imaging is currently a state of the art technique to guide RFCA for complex arrhythmias such as AF ablation, providing information on anatomical landmarks and arrhythmogenic substrate with higher accuracy and with less radiation exposure than fluoroscopy or conventional catheter based mapping. Importantly, accurate characterization of the arrhythmogenic substrate and the underlying mechanisms of the arrhythmia as well as visualization of anatomical landmarks are pivotal to optimize the results of RFCA. Comprehensive pre-procedural evaluation may help to identify the appropriate substrate as well as to identify patients with a high likelihood to benefit from a RFCA procedure. Show less
Ventricular tachyarrhythmias, the major cause of sudden unexpected cardiac arrest, occur specifically in patients with structural heart disease. In general, all types of structural heart disease... Show moreVentricular tachyarrhythmias, the major cause of sudden unexpected cardiac arrest, occur specifically in patients with structural heart disease. In general, all types of structural heart disease may lead to chronic heart failure, a severe condition with an additional high risk of atrial- and ventricular tachyarrhythmias. The thesis starts with a general overview (chapter 1) of the epidemiology, pathofysiology, prognosis and therapeutical options of heart failure. In this overview all subjects of study of the following chapters are introduced and explained. Next, attention is focused on clinical ventricular tachyarrhythmias. Chapter 2-5 of this thesis aim at evaluating the diagnostic approach, the therapeutical option of radiofrequency catheter ablation and the risk of recurrences in patients who had presented with a (malignant) ventricular tachyarrhythmia. The second part of this thesis (chapter 6-9) evaluates the effect of cardiac resynchronization therapy -a novel treatment option in patients suffering from heart failure- on the occurrence of atrial- and ventricular tachyarrhythmias. In addition the effect of cardiac resynchroniation therapy on patients with diabetes mellitus is evaluated. Show less
