ReviewCureus2024
Impact of Imaging and Pharmacological Treatment Strategies in Refractory Ventricular Tachycardia in Critically Ill Patients: A Systematic Review.
Review in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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0 citing papers in PubMed.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ventricular tachycardia (VT) is a life-threatening arrhythmia often leading to sudden cardiac death, particularly in critically ill patients. Refractory VT, characterized by recurrent episodes requiring intervention, poses unique challenges for management, necessitating advanced diagnostic and therapeutic strategies. This systematic review evaluates the impact of imaging and pharmacological treatments in managing refractory VT in critically ill patients. A systematic literature search was conducted using keywords such as "refractory ventricular tachycardia", "critical illness", "imaging techniques", "pharmacological treatments", "antiarrhythmic drugs", "ICD interventions", and "non-invasive therapy". Databases searched included PubMed, Google Scholar, and Cochrane Library, identifying 1590 publications. After screening, 11 studies meeting the inclusion criteria were included in this review. Oral procainamide significantly reduced VT episodes but caused severe side effects in certain patients. Noninvasive interventions such as transcutaneous magnetic stimulation (TcMS) and noninvasive electrophysiology-guided radioablation reduced VT burden and antiarrhythmic drug (AAD) use, with TcMS decreasing VT episodes in the sham group (P < 0.001). Stereotactic body radiation therapy (SBRT) and stereotactic arrhythmia radiotherapy (STAR) reduced VT episodes. Ultrasound-guided stellate ganglion blockade decreased VT episodes (P < 0.001) within 24 hours. Catheter ablation improved composite outcomes, including ICD shocks and heart failure hospitalizations, compared to AAD therapy. Quality of life significantly improved with noninvasive therapies, though SBRT presented rare complications like pneumonitis. Imaging and pharmacological interventions effectively reduce VT burden and ICD interventions while showing varying safety profiles. However, the limited sample sizes, short follow-up durations, and heterogeneity across studies highlight the need for further high-quality research to establish long-term efficacy and safety.
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