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CorSalud
versión On-line ISSN 2078-7170
Resumen
DORANTES SANCHEZ, Margarita; CASTRO HEVIA, Jesús A. y CASTANEDA CHIRINO, Osmín. Role of the Purkinje system and right ventricular outflow tract in malignant ventricular arrhythmias and sudden death. CorSalud [online]. 2020, vol.12, n.1, pp. 77-84. Epub 01-Mar-2020. ISSN 2078-7170.
The Purkinje system and the right ventricular outflow tract play a pivotal role in relation to malignant ventricular arrhythmias (ventricular tachycardia and fibrillation, torsades de pointes) and sudden cardiac death. Details such as their pathophysiology, origin involvement (triggering extrasystoles) maintenance of such arrhythmias, and ablative possibilities to reduce recurrences and electrical storm events are discussed herein. The differential diagnosis between benign and malignant ventricular tachycardia related to the right ventricular outflow tract, and the relationship between genetic, structural, electroanatomical and functional factors (inflammation, fibrosis) with clinical events and vulnerability to arrhythmias are presented. Some of these diseases need to be reclassified as they are now seen in their organic-functional character (Brugada syndrome, for example), and this implies radical changes in some classical concepts as well as a new perspective on risk stratification and therapeutic management.
Palabras clave : Purkinje system; Right ventricular outflow tract; Premature ventricular contractions; Malignant ventricular arrhythmias.