Parmley W W
School of Medicine, University of California, San Francisco.
Am Heart J. 1987 Nov;114(5):1267-72. doi: 10.1016/0002-8703(87)90215-8.
Severe congestive heart failure (CHF) is a common syndrome with a high mortality rate (about 50% in 1 year among patients with symptoms at rest). Severity of left ventricular dysfunction is the most important adverse prognostic factor. Serious arrhythmias are common in CHF and also increase the mortality rate. Sudden death is the mode of death in about 40% of patients with severe heart failure. Multiple factors contribute to arrhythmias in CHF, including left ventricular dysfunction, myocardial ischemia, catecholamines, electrolyte disturbances, and drugs used to treat the heart failure. Minimizing or correcting these influences may be important in reducing serious arrhythmias. Antiarrhythmic drugs may be important in reducing the incidence of sudden death among patients with severe heart failure, although this has not yet been proved.
重度充血性心力衰竭（CHF）是一种常见综合征，死亡率很高（静息时有症状的患者1年内死亡率约为50%）。左心室功能障碍的严重程度是最重要的不良预后因素。严重心律失常在CHF中很常见，也会增加死亡率。猝死是约40%重度心力衰竭患者的死亡方式。CHF中导致心律失常的因素有多种，包括左心室功能障碍、心肌缺血、儿茶酚胺、电解质紊乱以及用于治疗心力衰竭的药物。尽量减少或纠正这些影响对于减少严重心律失常可能很重要。抗心律失常药物在降低重度心力衰竭患者的猝死发生率方面可能很重要，尽管这尚未得到证实。
