Vora Amit, Kulkarni Samhita
Glenmark Cardiac Centre, Smt. S.R. Mehta Cardiac Institute, India.
Glenmark Cardiac Centre, Smt. S.R. Mehta Cardiac Institute, India.
Indian Heart J. 2014 Jan-Feb;66 Suppl 1(Suppl 1):S113-9. doi: 10.1016/j.ihj.2013.12.049. Epub 2014 Jan 21.
Fatal ventricular arrhythmias and heart failure are the common modes of death in patients with cardiovascular diseases. Intracardiac defibrillator (ICD) implantation reduces arrhythmic mortality to a significant extent in the high risk patient. However, there continues to be a need for effective drug therapy to reduce the arrhythmic and overall mortality in patients with or without an ICD. Although anti-arrhythmic drugs (AAD) appear inferior to ICD, the role of beta-blockers and to an extent amiodarone along with non AAD like angiotensin converting enzyme inhibitors (ACE-I), mineralocorticoid blockers (MRB) and HMG-CoA reductase inhibitors (statins) need to be emphasized. There have been many drug trials and meta-analysis to this effect and we review the role of drugs especially in their ability to reduce arrhythmic mortality and sudden cardiac death (SCD). The focus is on post myocardial infarction (MI) and heart failure patients with a brief overview of role of drugs in channelopathies.
致命性室性心律失常和心力衰竭是心血管疾病患者常见的死亡方式。植入心脏内除颤器（ICD）在高危患者中可显著降低心律失常性死亡率。然而，仍然需要有效的药物治疗来降低有或没有ICD的患者的心律失常性死亡率和总体死亡率。尽管抗心律失常药物（AAD）似乎不如ICD，但β受体阻滞剂以及在一定程度上胺碘酮与非AAD如血管紧张素转换酶抑制剂（ACE-I）、盐皮质激素阻滞剂（MRB）和HMG-CoA还原酶抑制剂（他汀类药物）的作用需要得到强调。为此已经进行了许多药物试验和荟萃分析，我们回顾药物的作用，特别是它们降低心律失常性死亡率和心源性猝死（SCD）的能力。重点是心肌梗死（MI）后和心力衰竭患者，并简要概述药物在通道病中的作用。
