在早发性心室复合体诱导心肌病症中,是否和何时使用抗心律失常药物?
Bharat K Kantharia1,2,3, Arti N Shah1,2,4
1Division of Cardiology, Cardiovascular and Heart Rhythm Consultants, New York City, New York, USA.
Journal of cardiovascular electrophysiology
|September 7, 2023
概括
抗节律药物 (AADs) 对于治疗早发性心室复合体诱导心肌病 (PVC-CM) 至关重要,特别是在多态或表心PVC中. 当导管切除不是一个选择时,患者的选择是关键.
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:
- 早发性心室综合体 (PVCs) 是常见的心律失常症.
- 高PVC负担会导致PVC诱导的心肌病 (PVC-CM),即使没有结构性心脏病.
- 有效的PVC抑制可以逆转PVC-CM.
研究的目的:
- 确定抗心律失常药物 (AADs) 在治疗PVC-CM中的作用.
- 确定PVC-CM管理中AADs的指示和患者选择.
- 与导管切除 (CA) 相比,评估AAD的疗效和安全性.
主要方法:
- 在PubMed和其他搜索引擎搜索英语出版物的文学搜索.
- 关键词包括:早产腹腔综合体 (PVC),心肌病,抗不律性药物,导管切除和药理学药物.
- 出版物被审查并纳入分析; 遵守道德标准.
主要成果:
- 没有发现比较PVC-CM的AAD和CA的大型随机试验.
- β阻塞剂和通道阻塞剂对流出通道PVC有效.
- 类 Ic AAD 显示有效性,但不推用于冠状动脉疾病;阿米奥达龙是有效的,但不是第一线治疗无症状或功能障碍的异常性PVC.
结论:
- 在处理PVC-CM时,ADS起着重要作用.
- 适当的患者选择对于AAD治疗至关重要.
- 用于多态PVC,表心PVC以及当CA是禁忌,不可行或失败时,AADs是适用的.
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