[成人先天性心脏病患者的心律失常]。

Q4 Medicine
Katharina Franke, Monika Lüdemann, Maria B Gonzalez Y Gonzalez
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引用次数: 0

摘要

先天性心脏病患者的心律失常非常复杂,需要全面了解解剖结构、既往手术和介入治疗过程以及特定的电生理过程。室上性心动过速常见于紧急情况,应立即进行治疗,尤其是在存在潜在复杂畸形的情况下。出于血液动力学的考虑,建立窦性心律通常优于单纯的频率控制。与药物治疗相比,应首选导管消融术,尽管通常需要进行多次手术。此外,心动过缓在先天性心脏缺损中更为常见;抗心律失常药物可能会加重心动过缓。先天性心脏病患者与非先天性心脏病患者在起搏器植入的适应症和技术方面存在很大差异。复杂先天性心脏病患者发生血栓栓塞的风险增加;因此,有必要确定低阈值口服抗凝药的个体和早期适应症;直接口服抗凝药也可用于这一目的。在对心脏性猝死进行风险分层时,一般指南的原则往往并不适用,需要做出个性化的决定。最近,针对先天性心脏病制定了新的一般风险评分。先天性心脏病患者的心律失常治疗应始终与专业中心密切合作进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cardiac arrhythmias in adults with congenital heart disease].

In patients with congenital heart disease, cardiac arrhythmias are complex and require a thorough understanding of the anatomy, past surgical and interventional procedures, and the specific electric processes. Supraventricular tachycardias commonly present as emergency situations and should be treated immediately, particularly when there is an underlying complex malformation. Establishing sinus rhythm is usually superior to pure frequency control for hemodynamic reasons. Catheter ablation should be preferred over medical treatment, even though several procedures are often necessary. In addition, bradycardia is seen more frequently in congenital heart defects; this could be aggravated by antiarrhythmic drugs. There are significant differences between the indications and techniques used for pacemaker implantation in patients with congenital heart defects and those without. Patients with complex congenital heart diseases have an increased risk of thromboembolism; therefore, an individual and early indication for low-threshold oral anticoagulation is necessary; direct oral anticoagulants can also be used for this purpose. In risk stratification for sudden cardiac death, the principles of general guidelines are often not applicable, and individualized decisions are required. Recently, a new general risk score for congenital heart disease has been developed. The treatment of cardiac arrhythmias in patients with congenital heart disease should always be performed in close cooperation with specialized centers.

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来源期刊
Herzschrittmachertherapie und Elektrophysiologie
Herzschrittmachertherapie und Elektrophysiologie Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.10
自引率
0.00%
发文量
76
期刊介绍: Mit wissenschaftlichen Original- und Übersichtsarbeiten, Berichten über moderne Operationstechniken und experimentelle Methoden ist die Zeitschrift Herzschrittmachertherapie + Elektrophysiologie ein Diskussionsforum für Themen wie: - Zelluläre Elektrophysiologie - Theoretische Elektrophysiologie - Klinische Elektrophysiologie - Angewandte Herzschrittmachertherapie - Bradykarde und tachykarde Herzrhythmusstörungen - Plötzlicher Herztod und Risikostratifikation - Elektrokardiographie - Elektromedizinische Technologie - Experimentelle und klinische Pharmakologie - Herzchirurgie bei Herzrhythmusstörungen Mitteilungen der Arbeitsgruppen Herzschrittmacher und Arrhythmie der Deutschen Gesellschaft für Kardiologie - Herz und Kreislaufforschung e.V. (DGK) sowie Stellungnahmen und praktische Hinweise runden das breite Spektrum dieser Zeitschrift ab. Interessensgebiete: Kardiologie, Herzschrittmachertherapie, Herzschrittmachertechnologie, klinische Elektrophysiologie
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