Aurora Cardiovascular Services, Aurora St Luke's Medical Center, Milwaukee, Wisconsin 53215, USA.
Curr Opin Cardiol. 2012 Jan;27(1):13-8. doi: 10.1097/HCO.0b013e32834d84fd.
The numbers of patients with ongoing mechanical circulatory support (MCS) is expanding significantly. These patients continue to have significant risk of both atrial and ventricular arrhythmias with few guidelines to suggest appropriate therapeutic strategies. Cardiologists need to understand the risks and therapeutic alternatives for the management of arrhythmias in this complex patient population.
Survival on MCS has steadily improved. Therefore, the duration of time during which the patients are at risk for both atrial and ventricular arrhythmias has increased. Drug-based and/or device-based therapeutic interventions are frequently required to mitigate these risks.
MCS has become the mainstream therapy for the end-stage heart failure population. Atrial arrhythmias in this population can lead to decompensated heart failure or thromboembolism and therapeutic interventions include rate control, rhythm control, and adjusted anticoagulation regimens. Ventricular arrhythmias in this population can lead to decompensated heart failure, syncope, and sudden cardiac death. Therapeutic interventions include volume replenishment, antiarrhythmic drug therapy, defibrillators, and adjustment of left ventricular assist device (LVAD) parameters. MCS may also be indicated in selected patients with refractory ventricular arrhythmias.
正在进行机械循环支持（MCS）的患者数量显著增加。这些患者仍然存在心房和心室心律失常的高风险，但很少有指南可以提供适当的治疗策略。心脏病专家需要了解在这种复杂患者群体中管理心律失常的风险和治疗选择。
MCS 的生存率稳步提高。因此，患者面临心房和心室心律失常风险的时间增加了。经常需要药物和/或器械治疗干预来降低这些风险。
MCS 已成为终末期心力衰竭患者的主流治疗方法。该人群中的心房心律失常可导致心力衰竭失代偿或血栓栓塞，治疗干预包括控制心率、控制节律和调整抗凝方案。该人群中的心室心律失常可导致心力衰竭失代偿、晕厥和心源性猝死。治疗干预包括补充容量、抗心律失常药物治疗、除颤器和调整左心室辅助装置（LVAD）参数。对于有难治性室性心律失常的患者，MCS 也可能是指征。
