Антиаритмическая терапия: риск и польза

Д.П. Саливончик
Учреждение образования «Гомельский государственный медицинский университет»
Широкое использование антиаритмической терапии при распространенных нарушениях ритма и проводимости привели к регистрации проаритмогенных проявлений данных препаратов на ЭКГ с формированием устойчивых желудочковых тахиаритмий и, как следствие, фатальным исходам . Проведение рандомизированных исследований позволило изменить стратегию и тактику в лечении аритмий и стратифицировать перед лечением пользу и вред антиаритмической терапии, вероятность наступления внезапной сердечной смерти. Контроль факторов риска , оптимальная медикаментозная терапия, стратификация риска внезапной смерти, реваскуляризация, катетерная аблация, имплантация кардиовертеров-дефибрилляторов позволяют в разы снизить смертность от желудочковых аритмий и потребность в антиаритмической терапии.
ключевые слова: антиаритмическая терапия, желудочковая аритмия, побочные эффекты, осложнения, внезапная сердечно-сосудистая смерть, оптимальная медикаментозная терапия

для цитирования: Д.П. Саливончик. Антиаритмическая терапия: риск и польза. Неотложная кардиология и кардиоваскулярные риски. 2018, Т. 2. № 2. С. 438-449.

Antiarrhythmic therapy: harm and benefit
D. P. Salivonchik
The widespre ad use of antiarrhythmic therapy for common rhythm and conduction disorders led to the registration of pro-rhythmogenic manifestations of these ECG preparations with the form a tion of stable ventricular tachyarrhythmias and, consequently, fata loutcomes. Conducting randomized studies allowed changing the strategy and tactics in the treatment of arrhythmias and stratifying the benefit and harm of antiarrhyth mic therapy before treatment as well as the likelihood of sudden cardiac death. Control of risk factors, optimal drug therapy, stratification of the risk of sudden death, revascularization, catheter ablation, implantation of cardioverter-defibrillators can reduce deaths from ventricular arrhythmias and the need for antiarrhythmic therapy.
keywords: antiarrhythmic therapy, ventricular arrhythmia, side effects, complications, sudden cardiovascular death, optimal drug therapy

for references: D.P. Salivonchik. Antiarrhythmic Therapy: Risk and Benefit. Emergency Cardiology and CardiovascularRisks. 2018, vol. 2, № 2, pp. 438-449.

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