心力衰竭中心室性心律失常的当代管理
Contemporary management of ventricular arrhythmias in heart failure.
作者信息
Kariki Ourania, Georgopoulos Maximos, Katsillis Nikitas, Chatziantoniou Anastasios, Koskina Stavroula, Zygouri Andromahi, Saplaouras Athanasios, Bazoukis George, Gkouziouta Aggeliki, Vlachos Konstantinos, Dragasis Stylianos, Mililis Panagiotis, Adamopoulos Stamatis, Efremidis Michael, Letsas Konstantinos P
机构信息
Department of Cardiology, Onassis Cardiac Surgery Center Athens, Greece.
Department of Cardiology, Larnaca General Hospital Larnaca, Cyprus.
出版信息
Am J Cardiovasc Dis. 2023 Aug 15;13(4):207-221. eCollection 2023.
Enhanced ventricular arrhythmogenesis is commonly experienced by patients in the end-stage of heart failure spectrum. A high burden of ventricular arrhythmias can affect the ventricular systolic function, lead to unexpected hospitalizations and further deteriorate the prognosis. Management of ventricular arrhythmias in this population is challenging. Implantable cardioverter-defibrillators are protective for the immediate termination of life-threatening arrhythmias but they have no impact in reducing the arrhythmic burden. Combination treatment with invasive (catheter ablation, mechanical hemodynamic support, sympathetic denervation) and noninvasive (antiarrhythmic drugs, medical therapy for heart failure, programming of implantable devices) therapies is commonly required. The aim of this review is to present the available therapeutic options, with main focus on recently published data for catheter ablation and provide a stepwise treatment approach.
心力衰竭终末期患者常出现心室心律失常发生率增加的情况。高负荷的室性心律失常会影响心室收缩功能，导致意外住院，并进一步恶化预后。对这一人群的室性心律失常进行管理具有挑战性。植入式心脏复律除颤器对立即终止危及生命的心律失常具有保护作用，但对减轻心律失常负担并无影响。通常需要采用侵入性（导管消融、机械血流动力学支持、交感神经去神经支配）和非侵入性（抗心律失常药物、心力衰竭药物治疗、植入式设备程控）治疗相结合的方法。本综述的目的是介绍现有的治疗选择，主要关注最近发表的关于导管消融的数据，并提供一种逐步的治疗方法。
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