Fahed J, Floyd K C, Tighe D A
Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA -
Panminerva Med. 2015 Jun;57(2):71-86. Epub 2015 Feb 11.
Patients who survive a myocardial infarction are at increased risk for sudden death, owing largely to ventricular arrhythmia. In this article, we will review the epidemiology of sudden cardiac death in postmyocardial-infarction patients, arrhythmia mechanisms and substrate leading to cardiac arrest, identifying possible risk factors for sudden cardiac death (SCD) in high risk population and apply risk stratification strategies for prevention of SCD. We will also review relevant major trials and evidence-based therapy currently used, in addition to the indications and role of implantable cardioverter-defibrillators in this population. We will end this review with a summary of the current guidelines recommendations and a look into the future of this domain.
心肌梗死幸存者面临猝死风险增加,这主要归因于室性心律失常。在本文中,我们将综述心肌梗死后患者心源性猝死的流行病学、导致心脏骤停的心律失常机制和基质,确定高危人群心源性猝死(SCD)的可能危险因素,并应用风险分层策略预防SCD。我们还将综述相关的主要试验和目前使用的循证治疗方法,以及植入式心脏复律除颤器在该人群中的适应证和作用。我们将以当前指南建议的总结以及对该领域未来的展望结束本综述。