vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-1522vestar-1605Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCASE REPORTSКлинический случай лечения рефрактерной желудочковой тахикардии: от простого - к сложному, от нового - к старомуA clinical case of refractory ventricular tachycardia treatment: from simple to complex and back againhttps://orcid.org/0000-0002-2408-1541СарибекянА. Г.SaribekianA. G.

Сарибекян Анна Гевориковна

Москва, Петроверигский пер., д. 10

Anna Saribekian

Moscow, 10 Petroverigsky Lane

nairiann@mail.ruhttps://orcid.org/0000-0001-6624-046XАбдуллаевА. М.AbdullaevA. M.

Москва, Петроверигский пер., д. 10

Moscow, 10 Petroverigsky Lane

https://orcid.org/0000-0003-3788-3997ДавтянК. В.DavtyanK. V.

Москва, Петроверигский пер., д. 10

Moscow, 10 Petroverigsky Lane

https://orcid.org/0000-0002-0488-2560ЧарчянЭ. Р.CharchyanE. R.

Москва, Абрикосовский пер., д. 2

Moscow, 2 Abrikosovsky Lane

ФГБУ «НМИЦ терапии и профилактической медицины» МЗ РФРоссияFSBI «NMRC for Therapy and Preventive Medicine» of the MH RFRussian FederationГБУ «НМИЦ терапии и профилактической медицины» МЗ РФРоссияFSBI «NMRC for Therapy and Preventive Medicine» of the MH RFRussian FederationФГБНУ «РНЦХ им. акад. Б.В.Петровского»РоссияFSBSI «RSC of Surgery named after Academician B.V. Petrovsky»Russian Federation2025130120263246570Copyright © Сарибекян А.Г., Абдуллаев А.М., Давтян К.В., Чарчян Э.Р., 20262026Сарибекян А.Г., Абдуллаев А.М., Давтян К.В., Чарчян Э.Р.Saribekian A.G., Abdullaev A.M., Davtyan K.V., Charchyan E.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/1605

Представлен клинический случай пациента с рецидивирующей рефрактерной желудочковой тахикардией (ЖТ) на фоне постинфарктного кардиосклероза. Несмотря на проведение оптимальной медикаментозной терапии и нескольких процедур катетерной аблации с использованием современных навигационных технологий, сохранялись эпизоды ЖТ. Ключевым фактором неэффективности эндокардиального подхода оказалось интрамуральное расположение аритмогенных зон. В связи с этим было принято решение о выполнении хирургического вмешательства с криоаблацией рубцовых тканей. После операции достигнута стойкая ремиссия, что подтверждено данными регулярных проверок имплантируемого кардиовертера-дефибриллятора. Представленный случай подчёркивает значение индивидуализированного и мультидисциплинарного подхода при выборе тактики лечения пациентов с рефрактерной ЖТ

The article presents a clinical case of a patient with recurrent refractory ventricular tachycardia (VT) on the background of postinfarction cardiosclerosis. Despite optimal drug therapy and several catheter ablation procedures using modern navigation technologies, episodes of VT persisted. The key factor of ineffectiveness of the endocardial approach turned out to be the intramural location of arrhythmogenic zones. Therefore, a decision was made to perform surgical intervention with cryoablation of scar tissues. After the surgery, a stable remission was achieved, which was confirmed by the data of regular checks of the implantable cardioverter-defibrillator. The presented case emphasizes the importance of individualized and multidisciplinary approach in the choice of treatment tactics for patients with refractory VT.

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The authors declare that there are no conflicts of interest present.