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药物性房颤:致心律失常机制与管理策略

Drug-induced AF: Arrhythmogenic Mechanisms and Management Strategies.

作者信息

Li Bingxun, Lin Mingjie, Wu Lin

机构信息

Department of Cardiology, Peking University First Hospital Beijing, China.

Department of Cardiology, Qilu Hospital of Shandong University Qingdao Branch Qingdao, China.

出版信息

Arrhythm Electrophysiol Rev. 2024 Apr 3;13:e06. doi: 10.15420/aer.2023.24. eCollection 2024.

Abstract

AF is a prevalent condition that is associated with various modifiable and unmodifiable risk factors. Drug-induced AF, despite being commonly under-recognised, can be relatively easy to manage. Numerous cardiovascular and non-cardiovascular agents, including catecholaminergic agents, adenosine, anti-tumour agents and others, have been reported to induce AF. However, the mechanisms underlying drug-induced AF are diverse and not fully understood. The complexity of clinical scenarios and insufficient knowledge regarding drug-induced AF have rendered the management of this condition complicated, and current treatment guidelines follow those for other types of AF. Here, we present a review of the epidemiology of drug-induced AF and highlight a range of drugs that can induce or exacerbate AF, along with their molecular and electrophysiological mechanisms. Given the inadequate evidence and lack of attention, further research is crucial to underscore the clinical significance of drug-induced AF, clarify the underlying mechanisms and develop effective treatment strategies for the condition.

摘要

心房颤动是一种常见病症,与多种可改变和不可改变的风险因素相关。药物性心房颤动尽管常常未得到充分认识,但相对易于处理。据报道,包括儿茶酚胺能药物、腺苷、抗肿瘤药物等在内的众多心血管和非心血管药物可诱发心房颤动。然而,药物性心房颤动的潜在机制多种多样,尚未完全明确。临床情况的复杂性以及对药物性心房颤动的认识不足,使得这种病症的管理变得复杂,目前的治疗指南遵循其他类型心房颤动的指南。在此,我们对药物性心房颤动的流行病学进行综述,并着重介绍一系列可诱发或加重心房颤动的药物及其分子和电生理机制。鉴于证据不足且缺乏关注,进一步的研究对于强调药物性心房颤动的临床意义、阐明潜在机制以及制定针对该病症的有效治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/636c/11066853/56d65da884d6/aer-13-e06-g001.jpg

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