Holcman Katarzyna, Ząbek Andrzej, Boczar Krzysztof, Podolec Piotr, Kostkiewicz Magdalena
Department of Nuclear Medicine, John Paul II Hospital, 31-202 Krakow, Poland.
Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland.
J Clin Med. 2024 May 24;13(11):3088. doi: 10.3390/jcm13113088.
Cardiac amyloidosis, a condition characterized by abnormal protein deposition in the heart, leads to restrictive cardiomyopathy and is notably associated with an increased risk of arrhythmias and conduction disorders. This article reviews the current understanding and management strategies for these cardiac complications, with a focus on recent advancements and clinical challenges. The prevalence and impact of atrial arrhythmias, particularly atrial fibrillation, are examined, along with considerations for stroke risk and anticoagulation therapy. The article also addresses the complexities of managing rate and rhythm control, outlining the utility and limitations of pharmacological agents and interventions such as catheter ablation. Furthermore, it reviews the challenges in the treatment of ventricular arrhythmias, including the contentious use of implantable cardioverter-defibrillators for primary and secondary prevention. Individualized approaches, considering the unique characteristics of cardiac amyloidosis, are paramount. Continuous research and clinical exploration are essential to refine treatment strategies and improve outcomes in this challenging patient population.
心脏淀粉样变性是一种以心脏中异常蛋白质沉积为特征的疾病，可导致限制性心肌病，并且显著增加心律失常和传导障碍的风险。本文综述了对这些心脏并发症的当前认识和管理策略，重点关注近期进展和临床挑战。研究了房性心律失常尤其是心房颤动的患病率和影响，以及对中风风险和抗凝治疗的考量。本文还探讨了心率和节律控制管理的复杂性，概述了药物和诸如导管消融等干预措施的效用和局限性。此外，还回顾了室性心律失常治疗中的挑战，包括在一级和二级预防中使用植入式心脏复律除颤器的争议性。考虑到心脏淀粉样变性的独特特征，个体化方法至关重要。持续的研究和临床探索对于完善治疗策略以及改善这一具有挑战性患者群体的治疗结果至关重要。
