Acilde Ventriküler Aritmi Yönetimi
Özet
Ventriküler ritm bozuklukları veya aritmiler (VA), otomatisite artışı ve/veya re-entry gibi yollarla görülen antitelerdir. Sıklıkla taşikardik durumlar olmakla birlikte bradiaritmi şeklinde de ortaya çıkabilirler. VA tanısı konulan olgularda en sık etiyoloji iskemik kalp hastalıkları ve akut koroner sendromlardır. Ventriküler taşikardi ve diğer aritmilerde öncelikle bunlar dışlanmalıdır. Yönetimde tetikleyicilerin belirlenip giderilmesi, stabilizasyon öncelikli olmakla birlikte, şok ve/veya kalp yetersizliği gibi yaşamsal komplikasyonların olasılığının ortadan kaldırılması, sinüs ritminin sağlanması esastır. Uzun dönemde izlem ve komplikasyonların tedavisi için kardiyoloji ve diğer branşlarla iletişim önemlidir.
Referanslar
Neumar RW, Otto CW, Link MS, Kronick SL,Shuster M, Callaway CW, et al. Part 8: Adult advanced cardiovascular life support: 2010 Ameri can Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122: 729-67.
Pinto DS, Josephson ME. Ani kalp ölümü. In Fuster V, Alexander RW, O’Rourke RA. Hurst’s The Heart. 10. baskı. İstanbul. McGraw-Hill, 2002; 1015-48.
Samuels FL, Marchlinski FE. Ani Kardiyak Ölüm. In Craw¬ford MH, DiMarco JP: Crawford Kardiyoloji, Mosby 2003; 1- 10.
Clements EA, Kuhn BR. Pharmacology of antidysrhythmic and vasoac¬tive medications. In Tintinalli JE, Kelen GD, Stapczynski JS: Emergency Medicine A Comprehensive Study Guide. 6th ed. New York, McGraw-Hill, 2004; 202-217
Wong ML, Carey S, Mader TJ, Wang HE. Time to invasive airway placement and resuscitation outcomes after inhospital cardiopulmonary arrest. Resuscitation. 2010;81:182–186.
6. Task Force of the Working Group on Arrhythmias, the European Society of Cardiology. The Sicilian Gambit: a new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Circulation. 1991;84:1831–1851.
9. Rosen MR, Janse MJ. Concept of the vulnerable parameter: the Sicilian Gambit revisited. J Cardiovasc Pharmacol. 2010;55:428–437. doi: 10.1097/FJC.0b013e3181bfaddc
10. Mangoni ME, Nargeot J. Genesis and regulation of the heart automaticity. Physiol Rev. 2008;88:919–982. doi: 10.1152/physrev.00018.2007
12. Biel M, Wahl-Schott C, Michalakis S, Zong X. Hyperpolarization-activated cation channels: from genes to function. Physiol Rev. 2009;89:847–885. doi: 10.1152/physrev.00029.2008
13. Lei M, Zhang H, Grace AA, Huang CL. SCN5A and sinoatrial node pacemaker function. Cardiovasc Res. 2007;74:356–365. doi: 10.1016/j.cardiores.2007.01.009
24. National Institue of Health Care Excellence. Arrhythmias. 2014. https://bnf.nice.org.uk/treatment-summary/arrhythmias.html. Accessed September 21, 2018.
26. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death [published online October 30, 2017]. Circulation. https://www.ahajournals.org/
doi/10.1161/CIR.0000000000000548?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Page RL, Joglar JA, Caldwell MA, et al; Evidence Review Committee Chair. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133:e506–e574.
29. Sampson K, Kass R. Anti-arrhythmic drugs. In: Brunton L, Chabner B, Knollman B, eds. Goodman & Gilman’s The Pharmaceutical Basis of Therapeutics. New York, NY: McGrawHill; 2011:815–848.
35. Schmitt N, Grunnet M, Olesen SP. Cardiac potassium channel subtypes: new roles in repolarization and arrhythmia. Physiol Rev. 2014;94:609–653. doi: 10.1152/physrev.00022.2013
Dorian P, Cass D, Schwartz B, et al. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 2002 ; 347: 955.
Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, et al; PARAMEDIC2 Collaborators. A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med. 2018;379:711–721.
Referanslar
Neumar RW, Otto CW, Link MS, Kronick SL,Shuster M, Callaway CW, et al. Part 8: Adult advanced cardiovascular life support: 2010 Ameri can Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122: 729-67.
Pinto DS, Josephson ME. Ani kalp ölümü. In Fuster V, Alexander RW, O’Rourke RA. Hurst’s The Heart. 10. baskı. İstanbul. McGraw-Hill, 2002; 1015-48.
Samuels FL, Marchlinski FE. Ani Kardiyak Ölüm. In Craw¬ford MH, DiMarco JP: Crawford Kardiyoloji, Mosby 2003; 1- 10.
Clements EA, Kuhn BR. Pharmacology of antidysrhythmic and vasoac¬tive medications. In Tintinalli JE, Kelen GD, Stapczynski JS: Emergency Medicine A Comprehensive Study Guide. 6th ed. New York, McGraw-Hill, 2004; 202-217
Wong ML, Carey S, Mader TJ, Wang HE. Time to invasive airway placement and resuscitation outcomes after inhospital cardiopulmonary arrest. Resuscitation. 2010;81:182–186.
6. Task Force of the Working Group on Arrhythmias, the European Society of Cardiology. The Sicilian Gambit: a new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. Circulation. 1991;84:1831–1851.
9. Rosen MR, Janse MJ. Concept of the vulnerable parameter: the Sicilian Gambit revisited. J Cardiovasc Pharmacol. 2010;55:428–437. doi: 10.1097/FJC.0b013e3181bfaddc
10. Mangoni ME, Nargeot J. Genesis and regulation of the heart automaticity. Physiol Rev. 2008;88:919–982. doi: 10.1152/physrev.00018.2007
12. Biel M, Wahl-Schott C, Michalakis S, Zong X. Hyperpolarization-activated cation channels: from genes to function. Physiol Rev. 2009;89:847–885. doi: 10.1152/physrev.00029.2008
13. Lei M, Zhang H, Grace AA, Huang CL. SCN5A and sinoatrial node pacemaker function. Cardiovasc Res. 2007;74:356–365. doi: 10.1016/j.cardiores.2007.01.009
24. National Institue of Health Care Excellence. Arrhythmias. 2014. https://bnf.nice.org.uk/treatment-summary/arrhythmias.html. Accessed September 21, 2018.
26. Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death [published online October 30, 2017]. Circulation. https://www.ahajournals.org/
doi/10.1161/CIR.0000000000000548?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
Page RL, Joglar JA, Caldwell MA, et al; Evidence Review Committee Chair. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133:e506–e574.
29. Sampson K, Kass R. Anti-arrhythmic drugs. In: Brunton L, Chabner B, Knollman B, eds. Goodman & Gilman’s The Pharmaceutical Basis of Therapeutics. New York, NY: McGrawHill; 2011:815–848.
35. Schmitt N, Grunnet M, Olesen SP. Cardiac potassium channel subtypes: new roles in repolarization and arrhythmia. Physiol Rev. 2014;94:609–653. doi: 10.1152/physrev.00022.2013
Dorian P, Cass D, Schwartz B, et al. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 2002 ; 347: 955.
Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, et al; PARAMEDIC2 Collaborators. A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med. 2018;379:711–721.
