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| PREDICTORS
AND POSSIBILITIES OF PREVENTION MALIGNANT ARRHYTHMIAS |
|
A. Macić-Džanković |
| General
Hospital Sarajevo, Bosnia and Herzegovina |
Clinical
usefullnes of the late potentials, OT-prolongation and OT:dispersion,
T-wave alternans, heartf rekvency and RR-variability and baroreceptor
sensitivity as predictors of malignant arrhythmias, was commented.
Prerequisite for the induction of malignant ventricular arrhythmias,
ventricular tachycardia (VT) and/or ventricular fibrillation (VF),
is the coincidence of several factors, as underliving organic
heart disease left ventricular function, imbalance of autonomous
nervous system, hypokalemia, drugs and ischaemia. Preventive measures
include drugs, use of implantab cardioverter defibrillator (ICD)
therapy and antiischaemic interventions. All classes of antiarrhythmic
drugs, angiotensin converting enzyme inhibitors and statines were
elaluat. To investigate the potential effect of ICD therapy compared
to antiarrhythmic drug treatment, three prospective studies-AVID,
CASH and CIDS have been conducin wich patients with sustained
ventricular arrhythmias were randomised to one of these two treatment
strategies. Data from these trials provide support for ICD as
a superior therapy to antiarrhythmic drugs, to prolong survival
in patients meeting the entry criteria. Antiischaemic interventions
(PTCA, CABG) can abolish ischaemia as an important trigger of
arrhythmia ind tion, but reports concerning the effects of antiiscaemic
interventions as preventive measure for arrhythmogenic events
are lacking.
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