Mihálcz Attila, Abrahám Pál, Kardos Attila, Földesi Csaba, Szili-Török Tamás
Gottsegen György Országos Kardiológiai Intézet Budapest Haller u. 29. 1096.
Orv Hetil. 2011 Oct 30;152(44):1757-63. doi: 10.1556/OH.2011.29204.
Atrial fibrillation and chronic heart failure are two major and even growing cardiovascular conditions that often coexist. Cardiac resynchronization therapy is an important, device-based, non-pharmacological approach in a selected group of chronic heart failure patients that has been shown to improve left ventricular function and to reduce both morbidity and mortality in large randomized trials. The latest European and American guidelines have considered atrial fibrillation patients with heart failure eligible for cardiac resynchronization therapy. This review summarizes current literature concerning the following topics: prognostic relevance of atrial fibrillation in heart failure, effects of cardiac resynchronization therapy in atrial fibrillation, relevance and strategies of rhythm and rate control in this group of patients. Authors explain how atrial fibrillation may interfere with the delivery of adequate cardiac resynchronization therapy, how to reduce the burden of atrial tachyarrhythmias, and finally present a brief overview.
心房颤动和慢性心力衰竭是两种主要且发病率不断上升的心血管疾病,它们常常并存。心脏再同步治疗是针对特定慢性心力衰竭患者群体的一种重要的、基于器械的非药物治疗方法,大型随机试验已表明该方法可改善左心室功能,并降低发病率和死亡率。最新的欧美指南已将合并心力衰竭的心房颤动患者纳入心脏再同步治疗的适用范围。本综述总结了有关以下主题的当前文献:心房颤动在心力衰竭中的预后相关性、心脏再同步治疗对心房颤动的影响、该患者群体中节律和心率控制的相关性及策略。作者解释了心房颤动如何干扰充分的心脏再同步治疗的实施、如何减轻房性快速性心律失常的负担,并最终进行简要概述。