Erath Julia W, Hohnloser Stefan H
J.W. Goethe University, Dep. of Cardiology, Div. of Clinical Electrophysiology, Frankfurt am Main, Germany.
J.W. Goethe University, Dep. of Cardiology, Div. of Clinical Electrophysiology, Frankfurt am Main, Germany.
Int J Cardiol. 2017 Jun 15;237:22-24. doi: 10.1016/j.ijcard.2017.03.066. Epub 2017 Mar 18.
Sudden cardiac death (SCD) remains a major public health burden despite enormous advances in post-resuscitation care, management of structural heart diseases, and antiarrhythmic treatment modalities. Primary and secondary prevention of sudden cardiac death require understanding of the underlying substrate causing ventricular arrhythmias and its modification by pharmacological (i.e. heart failure therapy) or interventional (catheter ablation) methods. Antiarrhythmic drug therapy has experienced ups and downs during the last 30years balancing high antiarrhythmic potential, toxic side effects and pro-arrhythmic potency. Therefore, the implantable cardioverter-defibrillator (ICD) remains irreplaceable in primary and secondary prevention of SCD. Hybrid therapy combing antiarrhythmic drugs (predominantly amiodarone) with ICD therapy represents an often-used treatment option. This short review provides an overview of current pharmacological therapy aiming to prevent SCD.
尽管在心肺复苏后护理、结构性心脏病管理和抗心律失常治疗方式方面取得了巨大进展，但心脏性猝死（SCD）仍然是一项重大的公共卫生负担。心脏性猝死的一级和二级预防需要了解导致室性心律失常的潜在基质，以及通过药物（即心力衰竭治疗）或介入（导管消融）方法对其进行修正。在过去30年中，抗心律失常药物治疗经历了起起落落，需要在高抗心律失常潜力、毒副作用和促心律失常效力之间取得平衡。因此，植入式心脏复律除颤器（ICD）在心脏性猝死的一级和二级预防中仍然不可替代。将抗心律失常药物（主要是胺碘酮）与ICD治疗相结合的混合疗法是一种常用的治疗选择。这篇简短的综述概述了目前旨在预防心脏性猝死的药物治疗。
