心室节律失常和心脏突然死亡
Roy M John1, Usha B Tedrow, Bruce A Koplan
1Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. rjohn2@partners.org
Lancet (London, England)
|October 30, 2012
概括
植入式心脏转移器除器 (ICD) 能够控制心室节律失常并减少心脏突然死亡. 导管切除和抗心律失常药物有助于控制症状,减少心律失常的频率,改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
背景情况:
- 心室节律失常会导致心脏突然死亡和症状严重程度的风险.
- 目前的管理策略平衡风险分层与治疗干预.
研究的目的:
- 审查目前对心室节律失常的管理策略.
- 讨论可植入心脏转换器除器,抗失律药物,导管切除和手术的作用.
主要方法:
- 审查关于心室心律失常管理的现有文献.
- 分析各种治疗方式的疗效和局限性.
主要成果:
- 植入式心脏转移器除器 (ICD) 对于高风险突然死亡的患者至关重要.
- 抗节律药物主要用于治疗症状性心律失常,而导管切除为特定患者提供治愈潜力.
- 外科干预仅适用于耐火病例.
结论:
- 基因理解,映射/消去技术和设备算法的进步增强了心室心律失常的管理.
- 结合器件,药物和切除的综合方法可以改善患者的治疗结果并降低死亡率.
相关概念视频
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.
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 II: Classification of Tachyarrhythmias
Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
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...
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...

