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[心动过速与肺动脉高压]

[Tachycardia and pulmonary arterial hypertension].

作者信息

Bandorski D, Bogossian H, Ghofrani A, Schmitt J, Höltgen R

机构信息

Medizinische Fakultät, Semmelweis Universität, Campus Hamburg, Lohmühlenstraße 5/Haus P, 20099, Hamburg, Deutschland.

Intensivmedizin und internistische Diagnostik, Neurologische Klinik Bad Salzhausen, Am Hasensprung 6, 63667, Nidda, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2020 Mar;31(1):33-38. doi: 10.1007/s00399-020-00668-w. Epub 2020 Feb 11.

Abstract

Pulmonary hypertension is newly defined as an elevation of the mean pulmonary arterial pressure >20 mmHg and a pulmonary vascular resistance ≥3 Wood units. Arrhythmias are an increasing problem in patients with pulmonary hypertension. Pathophysiological aspects leading to supraventricular arrhythmias are atrial fibrosis caused by increased right atrial pressure and dilation. An increased sympathetic tone leads to prolongation of action potential and delayed polarisations causing arrhythmias. Therapy of arrhythmias includes drugs (preferred amiodarone) and electrophysiological therapy like electric cardioversion and ablation, which is safe in patients with pulmonary hypertension.

摘要

肺动脉高压新定义为平均肺动脉压>20 mmHg且肺血管阻力≥3伍德单位。心律失常在肺动脉高压患者中是一个日益严重的问题。导致室上性心律失常的病理生理因素包括右心房压力升高和扩张引起的心房纤维化。交感神经张力增加导致动作电位延长和极化延迟,从而引起心律失常。心律失常的治疗包括药物(首选胺碘酮)和电生理治疗,如电复律和消融,这对肺动脉高压患者是安全的。

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