Tratamiento no farmacológico con cambios en el modo de vida

Ventricular tachycardias and ventricular fibrillation are seen with myriad electrical abnormalities in the ‘structurally normal heart’. They can occur in the assumed ‘electrically normal heart’ as well as with idiopathic VF. The overlap in these various conditions (RVOT-VT and ARVC, CPVT and ARVC, long QT3 and Brugada syndrome) suggests that there is a common genetic/molecular thread that runs through all these conditions. The search for the ‘Holy Grail’ of risk stratification is an enduring task in these uncommon to extremely rare conditions. At the present time, the ICD seems to be our only sure means of defense in these conditions. Unfortunately, patients with some of these conditions manifest with an index episode of aborted sudden cardiac death before they can be identified. Further research will shed light on the mechanisms involved in these electrical abnormalities and may generate a unifying common pathway of arrhythmogenesis. This will also translate into better identifying therapeutic targets for pharmacologic intervention. In cases of idiopathic VF, identification of an electrical marker before the first cardiac event would be ideal. Developing better therapy for these unfortunate young patients aims at improving outcomes and extending survival.

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