肺移植后心房节律失常的管理
Jacopo Marazzato1, Matthias Eikermann2, Luigi Di Biase3
1Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
JACC. Clinical electrophysiology
|August 30, 2023
概括
肺移植后心房律乱的管理是复杂的. 术后β-阻断剂和阿米奥达龙可能是有害的,但特定的低剂量β-阻断剂和替代性抗心律失常药对这些肺移植患者来说是有希望的.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 移植医学 移植医学
背景情况:
- 肺移植的存活率仍然很差,心房失常症显著导致发病率和死亡率.
- 肺移植患者手术后心房律乱的当前管理策略存在争议,缺乏明确的指导方针.
研究的目的:
- 审查目前关于肺移植后心房律乱病管理的文献.
- 提出一种实用的临床方法来管理肺移植接受者的这些并发症.
主要方法:
- 综合性文献综述,重点关注肺移植后心房律乱的临床和干预管理.
- 对各种药物和干预治疗方法的疗效和安全性现有数据的分析.
主要成果:
- 手术技术可能会导致心律失常;外科手术期间的β抑制剂和阿米奥达龙可能会有害.
- 低剂量的术后β-阻塞剂可能有助于在特定患者的预防;替代性抗失常药物对症状治疗是有效的.
- 射频导管切除是晚期发生的复杂心房律乱的一个可行的选择.
结论:
- 由于缺乏最终建议,建议采用实际的管理方法.
- 从更大规模的前性研究中进行进一步的研究对于优化治疗策略和改善患有心律失常的肺移植患者的治疗结果至关重要.
更多相关视频
相关概念视频
Dysrhythmias VI: Management of Dysrhythmias
19
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...
19
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Cardiomyopathy V: Interprofessional Care
14
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
14
Mitral Stenosis III: Medical Management
12
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
12
Disturbances in Heart Rhythm
1.0K
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...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K
Mitral Stenosis IV: Nursing Management
14
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
14


