Sawhney Navinder, Narayan Sanjiv M
University of California, San Diego, California 92161, USA.
Heart Rhythm. 2009 Mar;6(3 Suppl):S15-21. doi: 10.1016/j.hrthm.2008.10.006. Epub 2008 Oct 10.
Stratifying the risk for sudden cardiac arrest (SCA) in individuals with preserved systolic function remains a pressing public health problem. Current guidelines for the implantation of cardiac defibrillators largely ignore patients with preserved systolic function, even though they account for the majority of cases of SCA. Risk stratification for such individuals may be increasingly feasible. Notably, most individuals who experience SCA have structural heart disease, even if undiagnosed. Thus, clinical risk scores have been developed to identify individuals at high risk. Moreover, there are now promising data that T-wave alternans, alone and in combination with other indices, effectively predicts SCA in this population. This article presents our current understanding of SCA caused by ventricular arrhythmias in patients with preserved left ventricular systolic function, and attempts to build a framework to predict risk in this population.
对左心室收缩功能正常的个体进行心脏骤停（SCA）风险分层仍然是一个紧迫的公共卫生问题。目前的心脏除颤器植入指南很大程度上忽略了左心室收缩功能正常的患者，尽管他们占SCA病例的大多数。对这类个体进行风险分层可能越来越可行。值得注意的是，大多数发生SCA的个体都有结构性心脏病，即使未被诊断出来。因此，已经开发了临床风险评分来识别高危个体。此外，现在有很有前景的数据表明，T波交替，单独或与其他指标结合，能有效预测该人群的SCA。本文阐述了我们目前对左心室收缩功能正常的患者室性心律失常所致SCA的理解，并试图构建一个预测该人群风险的框架。
