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Titolo:
Arrhythmias in heart failure: Current concepts of mechanisms and therapy
Autore:
Eckardt, L; Haverkamp, W; Johna, R; Bocker, D; Deng, MC; Breithardt, G; Borggrefe, M;
Indirizzi:
Hosp Univ Munster, Dept Cardiol & Angiol, Munster, Germany Hosp Univ Munster Munster Germany pt Cardiol & Angiol, Munster, Germany Hosp Univ Munster, Inst Arteriosclerosis Res, Munster, Germany Hosp Univ Munster Munster Germany rteriosclerosis Res, Munster, Germany Hosp Univ Munster, Dept Cardiothorac Surg, Munster, Germany Hosp Univ Munster Munster Germany t Cardiothorac Surg, Munster, Germany
Titolo Testata:
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
fascicolo: 1, volume: 11, anno: 2000,
pagine: 106 - 117
SICI:
1045-3873(200001)11:1<106:AIHFCC>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
IDIOPATHIC DILATED CARDIOMYOPATHY; NONSUSTAINED VENTRICULAR-TACHYCARDIA; PROGRAMMED ELECTRICAL-STIMULATION; PAROXYSMAL ATRIAL-FIBRILLATION; ANTIARRHYTHMIC-DRUG-THERAPY; CORONARY-ARTERY DISEASE; ISOLATED RABBIT HEART; TORSADES-DE-POINTES; SHORT ATRIOVENTRICULAR DELAY; ACUTE MYOCARDIAL-INFARCTION;
Keywords:
heart failure; arrhythmia; antiarrhythmic drug; implantable cardioverter defibrillator;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
149
Recensione:
Indirizzi per estratti:
Indirizzo: Eckardt, L Univ Munster, Med Klin & Poliklin, Albert Schweitzer Str 33, D-48129 Munster, Germany Univ Munster Albert Schweitzer Str 33 Munster Germany D-48129
Citazione:
L. Eckardt et al., "Arrhythmias in heart failure: Current concepts of mechanisms and therapy", J CARD ELEC, 11(1), 2000, pp. 106-117

Abstract

About one half of deaths in patients with heart failure are sudden, mostlydue to ventricular tachycardia (VT) degenerating to ventricular fibrillation or immediate ventricular fibrillation, In severe heart failure, sudden cardiac death also may occur due to bradyarrhythmias. Other dysrhythmias complicating heart failure include atrial and ventricular extrasystoles, atrial fibrillation (AF), and sustained and nonsustained ventricular tachyarrhythmias. The exact mechanism of the increased vulnerability to arrhythmias isnot known. Depending on the etiology of heart failure, different preconditions, including ischemia or structural alterations such as fibrosis or myocardial scarring, may be prominent, Reentrant mechanisms around scar tissue,afterdepolarizations, and triggered activity due to changes in calcium metabolism significantly contribute to arrhythmogenesis. Furthermore, alterations in potassium currents leading to action potential prolongation and an increase in dispersion of repolarization play a significant role, Treatment of arrhythmias is necessary either because patients are symptomatic or to reduce the risk for sudden cardiac death. The individual history, left ventricular function, electrophysiologic testing, and the signal-averaged ECG give useful information for identifying patients at risk for sudden cardiac death. The implantable cardioverter defibrillator (ICD) has evolved as a promising therapy for life-threatening arrhythmias. A potential role may existfor antiarrhythmic drugs, mainly amiodarone, There is growing evidence that patients with sustained VT or a history of resuscitation have the best outcome with ICD therapy regardless of the degree of heart failure. Many of these patients require additional antiarrhythmic therapy because of AF or nonsustained VTs that may activate the device. Catheter ablation or map-guided endocardial resection are additional options in selected patients but seldom represent the only therapeutic strategy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 14:12:40