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心臓の先天性疾患を有する成人の心房不律
Judith Bouchardy1, Judith Therrien, Louise Pilote
1McGill Adult Unit for Congenital Heart Disease Excellence, McGill University Health Center and the Jewish General Hospital, Montreal, Quebec, Canada.
Circulation
|October 14, 2009
まとめ
心房不律症は,先天性心疾患を持つ成人に多く見られ,年齢とともに増加します. これらの心律乱は,この増加する患者集団における有害事象,死亡率,罹病率のリスクを大幅に高めます.
科学分野:
- 心臓病学 心臓病学
- 大人の先天性心疾患
- 電気生理学 電気生理学
背景:
- 心房不律症は,一般の成人の健康に重大な負担を及ぼします.
- 生まれながらの心疾患 (ACHD) を患っている成人は,心血管疾患の増加とともに,増加する人口を代表しています.
- この研究では,ACHD患者における心房不律症の罹患率と影響を調査しています.
研究 の 目的:
- 心臓の先天性疾患を有する成人における心房不律の罹患率と生涯リスクを決定する.
- ACHD患者における心房不律症と死亡率および罹患率を含む健康上の結果との関連性を評価する.
- ACHD集団における心房不律症の将来の負担を予測する.
主な方法:
- 1983年から2005年のデータを用いて,人口ベースの分析を行った.
- 心臓発作の有病率,生涯リスク,死亡率,および心房不律に関連した罹病率は,先天性心疾患を有する成人において分析されました.
- 統計的分析には,心房不律症と心房不律症の患者の有害事象を比較するための危険比が含まれていました.
主要な成果:
- 2005年,先天性心疾患の38,428人の成人のうち15%が心房不律を発症していた.
- 心房不律を発症する20年間のリスクは,20歳の7%から50歳の38%に増加した.
- 心房不律症は,有害事象のリスクが2.5倍,死亡率が47%増加,罹患率 (脳卒中/心不全) が2倍,心臓手術のリスクが3倍と関連していた.
結論:
- 心房不律は,先天性心疾患を持つ成人の15%に影響し,年齢とともに増加します.
- これらの心律乱は,ACHD患者における有害事象のリスクの倍増と関連しています.
- この増大する負担を管理するために,医療資源の配分を増加させる必要がある.
関連する概念動画
Disturbances in Heart Rhythm
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Mechanism of Cardiac Arrhythmias
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism, and...
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism, and...
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...

