Koenig A, Chauvin M, Thévenin D, Brechenmacher C
Service de Cardiologie, CMCO, Schiltigheim.
Presse Med. 1991 May 25;20(20):950-5.
Almost 50 percent of patients with chronic heart failure die of sudden death often due to arrhythmia. In these patients the prognosis is related to the severity of myocardial lesions and also, probably, to the presence of ventricular arrhythmias. The potential severity of which can be assessed by various methods, including ECG, Holter monitoring, late potentials study and programmed ventricular stimulation tests. The first therapeutic measure to improve the prognosis of heart failure is to improve the myocardial function by prescribing converting enzyme inhibitors. The second measure consists of acting on potentially dangerous ventricular arrhythmias with few or no symptoms. Among antiarrhythmic agents, only beta-blockers and amiodarone seem to be valuable.
近50%的慢性心力衰竭患者死于猝死，通常是由于心律失常。在这些患者中，预后与心肌病变的严重程度有关，也可能与室性心律失常的存在有关。其潜在严重程度可通过多种方法评估，包括心电图、动态心电图监测、晚电位研究和程控心室刺激试验。改善心力衰竭预后的首要治疗措施是通过使用转换酶抑制剂来改善心肌功能。第二项措施是针对几乎没有症状或无症状的潜在危险室性心律失常采取行动。在抗心律失常药物中，似乎只有β受体阻滞剂和胺碘酮有价值。
