Ventricular Arrhythmias in Acute Coronary Syndrome Patients:Therapy of Electrical Storm

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 345

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شناسه ملی سند علمی:

ICACSMED02_021

تاریخ نمایه سازی: 30 دی 1397

چکیده مقاله:

SCD due to sustained VA is common in patients suffering from untreated acute coronary syndromes (ACS)Three or more separate episodes of VT/VF occurring within 24 hours are defined as electrical storm (ES).ES are the most dangerous heart rhythm disturbance due to high risk of sudden cardiac death (SCD)The incidence of VA depends on size of ischemic area, magnitude of autonomic imbalance, extend of acute strain as well as prior heart failure, reduced left ventricular function (EF > 30%) and myocardial infarction .This review summarizes different therapeutic options in patients with ACS and malignant VT/VF .Prompt revascularisation and drug therapy, including anti-platelets, statins, angiotensin converting enzyme (ACE)-inhibitors and betablockers, have markedly reduced the incidence of VA .As therapeutic options AAD therapy, ICD therapy, RFA, stellate ganglion blockade, and RD are available. The treatment option with AAD is limited due to moderate efficacy. Supplementary drug therapy with ranolazine may be considered in addition to AAD in individual patients. The advantage of ICD therapy for primary or secondary prophylaxis has been well documented. ICD therapy is associated with significant reduction in mortality compared with AAD (mainly amiodarone), with the exception of beta-blockers. RFA, temporary stellate ganglion blockade and RD are therapeutically options for incessant VT or ES.Placement of a percutaneous LVAD might be required to perform an interventional therapy (mainly RFA) to suppress incessant VA or ES.

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