Eskisehir Osmangazi University, Faculty of Medicine, Department of Cardiology, ESOGÜ Meselik Kampüsü, Büyükdere Mahallesi, Prof. Dr Nabi AVCI Bulvarı No: 4 Odunpazarı, Eskisehir 26040, Turkey.
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
Europace. 2024 Oct 3;26(10). doi: 10.1093/europace/euae235.
Patients presenting with or alerting emergency networks due to acute heart failure (AHF) form a diverse group with a plethora of symptoms, risks, comorbidities, and aetiologies. During AHF, there is an increased risk of destabilizing the functional substrate and modulatory adding to the risk of ventricular arrhythmias (VAs) already created by the structural substrate. New VAs during AHF have previously identified patients with higher intra-hospital and 60-day morbidity and mortality. Risk stratification and criteria/best time point for coronary intervention and implantable cardioverter defibrillator implantation, however, are still controversial topics in this difficult clinical setting. The characteristics and logistics of pre-hospital emergency medicine, as well as the density of centres capable of treating AHF and VAs, differ massively throughout Europe. Scientific guidelines provide clear recommendations for the management of arrhythmias in patients with chronic heart failure. However, the incidence, significance, and management of arrhythmias in patients with AHF have been less studied. This consensus paper aimed to address the identification and treatment of VAs that complicate the course of patients who have AHF, including cardiogenic shock.
因急性心力衰竭（AHF）而出现或向紧急网络报警的患者构成了一个多样化的群体，具有多种症状、风险、合并症和病因。在 AHF 期间，功能基质的不稳定风险增加，并增加了已经由结构基质引起的室性心律失常（VA）的风险。新出现的 AHF 中的 VA 此前已确定了具有更高院内和 60 天发病率和死亡率的患者。然而，在这种困难的临床环境中，风险分层以及冠状动脉介入和植入式心脏复律除颤器植入的标准/最佳时间点仍然是有争议的话题。院前急救医学的特点和后勤工作，以及能够治疗 AHF 和 VA 的中心的密度，在整个欧洲差异巨大。科学指南为慢性心力衰竭患者心律失常的管理提供了明确的建议。然而，在 AHF 患者中，心律失常的发生率、意义和管理研究较少。本共识文件旨在解决困扰患有 AHF 包括心源性休克的患者的 VA 的识别和治疗问题。
