Лечение катехоламинергической полиморфной желудочковой тахикардии

Катехоламинергическая полиморфная желудочковая тахикардия (КПЖТ) является первичным электрическим заболеванием сердца, для которого характерно развитие полиморфной, в том числе двунаправленной, желудочковой тахикардии в ответ на адренергическую стимуляцию. Основным клиническим проявлением КПЖТ являются синкопальные состояния, провоцируемые физической или эмоциональной нагрузкой, введением адренергических препаратов. Для заболевания характерна высокая летальность при отсутствии лечения. Основной подход к лечению КПЖТ — медикаментозная терапия с применением бета-адреноблокаторов. Однако в последнее время появляется все больше работ, свидетельствующих о недостаточной их эффективности. Одним из подходов, предшествующих выбору интервенционных методов лечения у ряда больных, является назначение комбинированной терапии с добавлением антиаритмического препарата IC-класса. Интервенционные методы лечения включают имплантацию кардиовертера-дефибриллятора и левостороннюю симпатэктомию. В настоящей работе представлен современный взгляд на эффективность, безопасность и показания к выбору каждого из методов лечения больных с КПЖТ.

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