心臓発作の明示のない突然の不律性死
H J Wellens1, R Lemery, J L Smeets
1Department of Cardiology, Academic Hospital Maastricht, University of Limburg, Maastricht, The Netherlands.
Circulation
|January 1, 1992
まとめ
急性心律不全による死は,心疾患が知られていなくても起こる可能性があります. 薬剤に反応しない頻度の高い心房不律症は,予後が悪いことを示しており,世界的な患者レジストリが必要であることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心臓発作による突然死.
背景:
- 循環器の崩壊と突然の不律性死は,明らかな心臓病のない個体でも起こり得る.
- これらのイベントの根本的なメカニズムと最適な管理戦略は不明のままです.
研究 の 目的:
- 循環器の崩壊および/または不律性突然死を経験した一連の患者について報告する.
- この患者コホートにおける臨床的特徴,心律異常,およびアウトカムを調査する.
- 特定の電気生理学的発見の予後的意義と抗不律性治療の役割を探求する.
主な方法:
- 循環器崩壊のエピソードを持つ9人の患者を報告するケースシリーズ.
- 再蘇生中の心房細動および心房振動を含む心律不全の文書化.
- 頻度の高い早期心房早拍と持続しない多形心室性心拍不全の評価.
- 薬物療法への反応の評価と長期的な追跡.
主要な成果:
- 9人の患者のうち7人が心房細動を記録し,1人は心房の振動を経験しました.
- 4人の患者は,しばしば持続しない多形心室性心拍動脈と,頻繁な早期心室性早拍を患っていた.
- 薬物療法による子宮外活動抑制の失敗は,突然の死と再発性不律症を含む有害な結果と関連していました.
- 1人の患者は21ヶ月後に突然死亡し,2人の患者は再発性症状を発症した.
結論:
- 急性心律不全による死は,心疾患の明示がない場合でも起こり得るが,心室不律が重要な特徴である.
- 特に抗不律薬に反応しない場合の,持続的な頻繁な心室内外皮症は,著しい不良の予後を伴う.
- 希少性と不確実性を考慮して,これらのケースをよりよく理解し,管理するために,世界的なレジスタリが提案されています.
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