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在死亡的心哀病人中至少1/3是由心律紊乱而猝死的。血管扩张剂,尤其血管紧张素转化酶抑制剂的使用,已使总的心脏病死亡率降低,但心律紊乱性猝死发生率却并未下降,严重心衰病人ECG监护上室性异位活动和短串室速发生频率很高且常无症状。心律失常的频率和严重度通常与心衰之严重度相关,使在确定是否为死亡率独立危险因素很困难。可是短串室速与猝死有关,且抑制室性心律失常可以降低猝死的发生率。但到目前为止,抗心律失常治疗对心衰病人所起的作用仍有争论。广泛的看法是,惯用的抗心律失常药(例如Ⅰ类)常伴有抑制心肌、致心律失常等副作用,推荐常规预防性用于心衰伴频繁无症状室性心律紊乱认为不可取。
At least one-third of those who die of heart-sickness die suddenly from cardiac arrhythmias. The use of vasodilators, especially angiotensin-converting enzyme inhibitors, has resulted in a reduction in overall cardiac mortality but no decline in the incidence of sudden cardiac death. Ventricular ectopic activity on ECG monitoring in patients with severe heart failure and Short-term ventricular tachycardia frequency is high and often asymptomatic. The frequency and severity of arrhythmias are often associated with the severity of heart failure, making it difficult to determine whether an independent risk factor for mortality. However, short-term ventricular tachycardia and sudden death, and inhibition of ventricular arrhythmias can reduce the incidence of sudden death. But so far, the role of antiarrhythmic therapy in heart failure patients remains controversial. It is widely believed that conventional anti-arrhythmic drugs (such as class I) are often associated with side effects such as inhibition of cardiac muscle and arrhythmia. It is not advisable to recommend routine prophylaxis for heart failure with frequent asymptomatic ventricular arrhythmias.