[Lethal arrhythmias--etiological view and therapeutic approach].
Life threatening arrhythmias may cause sudden cardiac death and are divided into bradyarrhythmias and tachyarrhythmias. Most of lethal arrhythmias result from structural (fibrosis and scar due to ischemia) and functional(heart failure and autonomic nerve) abnormalities of the myocardium. But primary electrical diseases, which are caused by the abnormalities of the gene, may also develop lethal arrhythmias without such abnormalities. The treatment of lethal arrhythmias consists of pharmacologic, non-pharmacologic therapy and combination of those. Current meta-analysis have showed the efficacy of K channel blockers as an anti-arrhythmic drug for lethal tachyarrhythmias. Pacemaker therapy for brady-arrhythmia has been established as non-pharmacologic therapy. Additionally, radiofrequency catheter ablation is useful for some lethal arrhythmias but most case should be considered for implantation of ICD. Recently, upstream approach to arrhythmia has been emphasized and recognized as a preventive method for lethal arrhythmias.
Division of Cardiology, Yamaguchi Prefectural Central Hospital.
Takeshi
T
Ueyama
Kohshiro
K
Moritani
Akihiko
A
Shimizu
Hiroyuki
H
Kakugawa
Masunori
M
Matsuzaki
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001342:Autonomic Nervous System Diseases / Q000150:complications; D001919:Bradycardia / Q000209:etiology / Q000628:therapy; D017115:Catheter Ablation; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D019317:Evidence-Based Medicine; D006801:Humans; D007473:Ion Channels / Q000235:genetics; D015201:Meta-Analysis as Topic; D017202:Myocardial Ischemia / Q000150:complications; D026902:Potassium Channel Blockers / Q000627:therapeutic use; D013610:Tachycardia / Q000209:etiology / Q000628:therapy
D000889:Anti-Arrhythmia Agents; D007473:Ion Channels; D026902:Potassium Channel Blockers