[Arterial hypertension and cardiac arrhythmias]

Area of Science:

• Cardiology
• Electrophysiology
• Pharmacology

Context:

• Ventricular arrhythmias and atrial fibrillation (AF) are significant causes of morbidity and mortality.
• Risk factors include left ventricular hypertrophy, fibrosis, ischemia, apoptosis, and arterial hypertension.
• Current therapeutic strategies aim to suppress arrhythmias, prevent sudden cardiac death, and manage underlying conditions.

Purpose:

• To review current therapeutic approaches for ventricular arrhythmias and atrial fibrillation.
• To highlight the efficacy and limitations of various antiarrhythmic drugs and interventions.
• To emphasize the importance of risk factor modification and personalized treatment strategies.

Summary:

• Ventricular arrhythmias are managed with ACE inhibitors, angiotensin receptor antagonists, beta-blockers, and in specific cases, implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy.
• Atrial fibrillation management focuses on risk factor control (hypertension, hypertrophy), rate control, and rhythm control strategies, including antiarrhythmic agents and catheter ablation.
• Class-1 antiarrhythmic drugs are generally contraindicated in left ventricular hypertrophy and heart failure; amiodarone has a role but is limited by side effects.

Impact:

• Optimized treatment strategies can reduce the risk of sudden cardiac death and improve survival in patients with arrhythmias.
• Understanding the role of specific drug classes and interventions allows for more tailored and effective patient care.
• Further research into novel antiarrhythmic therapies and ablation techniques may offer improved long-term outcomes.