Rotem C E
Can Fam Physician. 1987 Nov;33:2637-43.
Arrhythmias are a frequent presenting symptom requiring further investigation. Not all arrhythmias are of clinical significance, and many need not be treated. Symptomatic and frequently recurring paroxysmal atrial tachycardia, atrial fibrillation with rapid ventricular response, the changing arrhythmias of the tachycardia-bradycardia syndrome should be investigated, and most should be treated. Frequent symptomatic ventricular premature beats need occasionally be treated when they interfere with a patient's quality of life, and when they are associated with serious underlying cardiac disease. Complex and sustained ventricular arrhythmias should be treated following thorough investigation because of the risk of sudden cardiac death. The range of available therapeutic options, pharmaceutical and non-pharmaceutical, has become quite bewildering. Many new anti-arrhythmic drugs have been, and are being, developed; all still have potential pro-arrhythmic effects. New electrosurgical procedures are available, as well as new implantable anti-arrhythmic pacemakers and automatic defibrillators.
心律失常是一种常见的症状，需要进一步检查。并非所有心律失常都具有临床意义，许多无需治疗。有症状且频繁复发的阵发性室上性心动过速、伴有快速心室反应的心房颤动、心动过速-心动过缓综合征中变化的心律失常应进行检查，多数应予以治疗。频繁发作的有症状室性早搏，当干扰患者生活质量或与严重潜在心脏病相关时，偶尔需要治疗。复杂且持续的室性心律失常因有心脏性猝死风险，应在全面检查后进行治疗。现有的治疗选择范围，包括药物和非药物治疗，已变得相当令人困惑。许多新型抗心律失常药物已经研发出来并且仍在不断研发；但它们都仍有潜在的促心律失常作用。新的电外科手术方法已经出现，还有新型植入式抗心律失常起搏器和自动除颤器。
