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Updated: May 12, 2026

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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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薬物 に よる 心律 乱れ: アメリカ 心臓 協会 の 科学 的 な 声明
Circulation
|September 15, 2020
まとめ
多くの一般的な薬剤は 危険な心律乱や ブルガダ症候群などの 深刻な心律乱を引き起こします 臨床医は薬剤による心律乱れを認識し,効果的な予防と管理を行う必要があります.
科学分野:
- 心臓病科
- 臨床薬理学
背景:
- 様々な治療法で用いられる多くの薬剤が 心律不全を引き起こしたり悪化させたりすることが知られている.
- QT間隔の延長と トルサデス・ド・ポインテスの誘発は 薬物の効果がよく知られていますが 他の不律も引き起こすことがあります
研究 の 目的:
- QT延長を超えた薬物誘発性不律のスペクトルを見直す.
- 薬剤誘発性心律乱症の臨床的意義,メカニズム,危険因子,管理戦略を強調する.
主な方法:
- 薬物誘発性不律症に関する研究の文献レビュー
- 薬剤による様々な不律のメカニズム,臨床表現,および管理ガイドラインの分析.
主要な成果:
- 薬剤は,ブラディアルリズム,心房細動/振動,心拍動,ブルガダ症候群を含む幅広い不律を誘発する.
- いくつかのメカニズムは理解されていますが,他のものは不明のままです. トルサデス・ド・ポインテスの危険因子は定義されており,高リスクの患者にはモニタリングが不可欠です.
結論:
- 鼓動不良を誘発する薬の認識は,臨床医にとって不可欠です.
- 管理には,薬物の中止,特定の心律不全の治療,過剰摂取の場合には解毒の検討が含まれます.
関連する概念動画
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.
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
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...
Dysrhythmias I: Introduction
Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...

