Biggs F D, Lefrak S S, Kleiger R E, Senior R M, Oliver G C
Heart Lung. 1977 Mar-Apr;6(2):256-61.
Patients with chronic obstructive lung disease have a high incidence and wide variety of cardiac arrhythmias. These arrhythmias are often clinically significant and may be life threatening. Although they occur particularly in the context of acute respiratory failure, arrhythmias are not infrequent in clinically stable patients. The relatively high incidence of sudden arrhythmias seen in acute respiratory failure are associated with a very poor prognosis, in particular, ventricular premature beats and multifocal atrial tachycardia. Long-term electrocardiographic monitoring is valuable in increasing the detection of these arrhythmias and in assessing their clinical significance and response to therapy. The mechanisms producing these arrhythmias are poorly understood and probably multiple. However, disturbances of blood gases, blood pH, and electrolytes or the presence of cor pulmonale or associated coronary artery disease is probably important. The therapy of these arrhythmias must include efforts to improve the patient's ventilatory status as well as careful use of standard antiarrhythmic drugs. Further investigation is needed to define the mechanisms, determine the prognosis, and improve the therapy of the arrhythmias found in chronic obstructive lung disease.
慢性阻塞性肺疾病患者心律失常的发生率高且种类繁多。这些心律失常在临床上往往具有重要意义，甚至可能危及生命。虽然它们尤其在急性呼吸衰竭的情况下发生，但在临床稳定的患者中也并不罕见。急性呼吸衰竭时相对较高的心律失常发生率与预后极差相关，特别是室性早搏和多源性房性心动过速。长期心电图监测对于增加这些心律失常的检出率、评估其临床意义及对治疗的反应具有重要价值。产生这些心律失常的机制尚不清楚，可能是多因素的。然而，血气、血液pH值和电解质紊乱或肺心病或相关冠状动脉疾病的存在可能很重要。这些心律失常的治疗必须包括努力改善患者的通气状态以及谨慎使用标准抗心律失常药物。需要进一步研究来明确机制、确定预后并改善慢性阻塞性肺疾病中发现的心律失常的治疗。
