[心跳加速-一种普遍现象]。

Q4 Medicine
Praxis Pub Date : 2025-05-01 DOI:10.23785/PRAXIS.2025.05.005
Octavia Diaconu, Christophe Wyss, Raffael Ghenzi
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引用次数: 0

摘要

背景:早搏是全科医生就诊的常见原因。在心脏病学文献中,特别是室上性心动过速往往起次要作用。本文讨论了目前的知识状况和常见的做法,为这一常见的临床问题。问题:由于人们健康意识的提高和新诊断技术(如智能手表)的使用,有症状或无症状性早搏的年轻健康患者就诊全科医生的人数有所增加。合并症在临床表现中起决定性作用。这篇综述综述了室上性和室性早搏,并明确提出了健康年轻人室性早搏的诊断和治疗方法。方法:在PubMed、EMBASE、Cochrane和Library数据库中进行有针对性的文献检索,检索词为:心动过速、室上性心动过速、室性心动过速、动态心电图监测、室性早搏(PVC)、房性早搏(PAC)、心率变异性、动态心电图监测,并考虑到欧洲心脏病学会(ESC)的现行指南。结果:共识别出54篇文献,并根据研究问题对其结果进行了评价。从中得出了全科医生处理这一问题的关键结论。结论:原则上,技术进步和人口可及性的扩大导致诊断程序的使用增加。根据最新的发现,对于初级保健提供者来说,重要的是要注意,即使是无症状的SVES -尽管原则上在隔离时是无害的-也不应该被忽视。早期发现和监测频繁发生SVES的个体,并结合心血管危险因素,有助于降低心血管事件的风险,包括卒中和其他与房颤相关的并发症。关于室性心动过速,应该注意的是,无症状且心室负荷低5%的个体不需要进一步调查。抗心律失常治疗在早搏的治疗中起着纯粹的对症作用,没有预后益处。近年来,导管消融变得越来越重要,在2022年的ESC指南中,它是治疗RVOT和左束支的症状性特发性室性心动过速的一线治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Extrasystole - a widespread phenomenon].

Introduction: Background: Extrasystole is a common reason for visits to general practitioners. In cardiological literature, supraventricular extrasystole in particular tends to play a minor role. This article discusses the current state of knowledge and common practice for this frequently encountered clinical problem. Question: Due to increasing health awareness among the population and the use of new diagnostic technologies (e.g. smartwatches), there has been an increase in GP consultations among young and healthy patients with symptomatic or asymptomatic extrasystole. Comorbidities play a decisive role in this clinical picture. This review provides an overview of supraventricular and ventricular extrasystoles and explicitly addresses the question of diagnostic and therapeutic approaches in the context of extrasystoles in healthy young people. Methodology: A targeted literature search was conducted in the PubMed, EMBASE, Cochrane and Library databases using the search terms: Extrasystole, supraventricular extrasystoles, ventricular extrasystoles, arrhythmia, tachycardia, ambulatory ECG monitoring, premature ventricular complex (PVC), premature atrial complex (PAC), heart rate variability, Holter ECG monitoring, taking into account the current guidelines of the European Society of Cardiology (ESC). Results: 54 publications were identified, the results of which were evaluated in line with the research question. From these, the key conclusions for general practitioners dealing with this issue were drawn. Conclusion: In principle, technological improvements and wider accessibility among the population lead to increased use of diagnostic procedures. According to the latest findings, it is important for primary care providers to note that even asymptomatic SVES - although in principle harmless when isolated - should not be ignored. Early detection and monitoring of individuals with frequent SVES in combination with cardiovascular risk factors could help reduce the risk of cardiovascular events, including strokes and other complications associated with atrial fibrillation. With regard to ventricular extrasystoles, it should be noted that asymptomatic individuals with a low VES burden of  5 % do not require further investigation. Antiarrhythmic therapy plays a purely symptomatic role in the treatment of extrasystoles and has no prognostic benefit. Catheter ablation has become increasingly important in recent years and is the first-line treatment for symptomatic, idiopathic ventricular extrasystoles from the RVOT and left bundle branch in the current ESC guidelines from 2022.

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来源期刊
Praxis
Praxis Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
146
审稿时长
12 weeks
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