心力衰竭的抗心律失常治疗。

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2024-02-01 Epub Date: 2024-01-15 DOI:10.1007/s11897-023-00642-w
Hilke Könemann, Sati Güler-Eren, Christian Ellermann, Gerrit Frommeyer, Lars Eckardt
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引用次数: 0

摘要

审查目的:心律失常是心力衰竭(HF)患者的常见病,与重大的死亡和发病风险相关。因此,最佳的抗心律失常治疗至关重要。在此,我们回顾了目前对心力衰竭患者进行抗心律失常治疗的方法:对于心房颤动,节律控制和心室率控制是公认的治疗策略。近年来,临床试验表明,早期节律控制策略和房颤导管消融对预后有益,尤其是射血分数降低的房颤患者。使用 ICD 治疗预防心脏性猝死至关重要,但最佳的风险分层具有挑战性。对于室性心动过速,最近的数据支持尽早考虑导管消融术。抗心律失常药物治疗是无症状患者的辅助治疗方法,但对预后无益,且有公认的(促心律失常)不良反应。心房颤动患者的抗心律失常治疗需要采用系统的多模式方法,从指南指导的心房颤动药物治疗开始,整合药物、器械和介入治疗。
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Antiarrhythmic Treatment in Heart Failure.

Purpose of review: Arrhythmias are common in patients with heart failure (HF) and are associated with a significant risk of mortality and morbidity. Optimal antiarrhythmic treatment is therefore essential. Here, we review current approaches to antiarrhythmic treatment in patients with HF.

Recent findings: In atrial fibrillation, rhythm control and ventricular rate control are accepted therapeutic strategies. In recent years, clinical trials have demonstrated a prognostic benefit of early rhythm control strategies and AF catheter ablation, especially in patients with HF with reduced ejection fraction. Prevention of sudden cardiac death with ICD therapy is essential, but optimal risk stratification is challenging. For ventricular tachycardias, recent data support early consideration of catheter ablation. Antiarrhythmic drug therapy is an adjunctive therapy in symptomatic patients but has no prognostic benefit and well-recognized (proarrhythmic) adverse effects. Antiarrhythmic therapy in HF requires a systematic, multimodal approach, starting with guideline-directed medical therapy for HF and integrating pharmacological, device, and interventional therapy.

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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
期刊最新文献
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