心力衰竭合并室性心律失常的治疗进展

各种心血管疾病发展到一定阶段,常常出现心力衰竭(心衰)和心律失常,这两种情况常同时出现又互相恶化。在心衰合并心律失常中,以室性心律失常多见且危害性大。恶性的室性心律失常可直接导致患者死亡,复杂类型的室性早搏和非持续性室速又与心衰患者的猝死发生密切相关。心衰合并室性心律失常在治疗时除基础疾病的治疗、心衰本身的纠正外,室性心律失常的处理有其特殊性。现介绍心衰时室性心律失常发生的机制、临床意义、各种检出方法的评价、治疗进展及猝死的综合预防措施。

Advances in Management of Ventricular Tachyarrhythmias Complicating with Congestive Heart Failure

Congestive heart failure(CHF) and cardiac arrhythmias are both complications in a developed stage of any cardiovascular disease.These two phenomena often coexist and create a vicious circle of negative effects.Among cardiac arrhythmias complicating with CHF,ventricular tachyarrhythmia (VTA) is the most common and most dangerous.Malignant VTAs are life threatening,and the complex premature ventricular beats and non-sustained ventricular tachycardia have a high incidence of sudden cardiac death under the background of CHF.Special attention must be paid to the treatment of VTA,in addition to the medication of both CHF and the cardiovascular disease itself.This article deals with current knowledge and developments concerning management of VTAs related to CHF.These include mechanisms,detection,clinical importance,developments in pharmacological and non-pharmacological therapies and the prevention of sudden cardiac death.