Fischer Avi, Verma Rajiv, Gomes Joseph A, Mehta Davendra
Section of Electrophysiology, The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
Mt Sinai J Med. 2002 Sep;69(4):197-207.
The control of life-threatening arrhythmias in the prevention of sudden cardiac death has been a long-standing challenge to clinicians. Large-scale, randomized, controlled trials have contributed immensely to our understanding of the management of life-threatening arrhythmias. There are many causes of life-threatening ventricular arrhythmias, which they occur mostly in the setting of healed myocardial infarction. Available treatments for the management of ventricular arrhythmias include antiarrhythmic drugs, implantable cardioverter defibrillators and catheter ablation. Each therapy provides unique advantages for selected patients with life-threatening arrhythmias. Because the goal of arrhythmia management is not only to provide the single best therapy but to provide the greatest assurance of symptomatic arrhythmia control, the use of combined therapy has become a standard treatment strategy for patients with sustained ventricular arrhythmias. This review will discuss the different modes of treatment available for the treatment of life-threatening ventricular arrhythmias, and their potential risks and benefits. The rationale for using hybrid or combination therapy will be presented. Finally, some of the better-known primary and secondary prevention trials for treatment of ventricular tachycardias will be reviewed.
在预防心源性猝死方面，控制危及生命的心律失常一直是临床医生面临的长期挑战。大规模、随机、对照试验极大地增进了我们对危及生命的心律失常管理的理解。危及生命的室性心律失常有多种原因，大多发生在心肌梗死愈合的情况下。用于管理室性心律失常的现有治疗方法包括抗心律失常药物、植入式心脏复律除颤器和导管消融术。每种治疗方法都为选定的危及生命的心律失常患者提供了独特的优势。由于心律失常管理的目标不仅是提供单一的最佳治疗方法，而且是提供最大程度的有症状心律失常控制保证，联合治疗已成为持续性室性心律失常患者的标准治疗策略。本综述将讨论可用于治疗危及生命的室性心律失常的不同治疗模式，以及它们潜在的风险和益处。还将介绍使用混合或联合治疗的基本原理。最后，将回顾一些治疗室性心动过速的著名一级和二级预防试验。
