Avtor/Urednik		Vokač, Damijan; Kotnik, Milan
Naslov		Motnje ritma ob akutnem koronarnem sindromu
Prevedeni naslov		Cardiac arrhythmias induced by ischemia in set of acute coronary syndrome
Tip		članek
Vir		In: Hojs R, Krajnc I, Pahor A, et al, editors. Zbornik predavanj in praktikum Iz prakse za prakso z mednarodno udeležbo. 13. srečanje internistov in zdravnikov splošne medicine; 2002 maj 10-11; Maribor. Maribor: Splošna bolnišnica Maribor,
Leto izdaje		2002
Obseg		str. 111-22
Jezik		slo
Abstrakt		Several types of specific therapy of ischemic disease of the heart as beta blockers, thrombolytic therapy and interventional procedures have lowered the incidence of cardiac arrhythmias triggered by ischemia. Several electrophysiological disorganizations during acute ischemia as changes of transmembrane potential, increased extracellular potassium, a decrease in conduction velocity, an increase in dispersion of refractoriness in addition to increased and inhomogeneous influence of catecholamines have led towards increased susceptibility for ventricular fibrillation (VF). In the acute phase of ischemia reentrant mechanisms of triggering VF are predominant, while in the late phase of ischemia a triggered activity and an increase in automaticity are predominant. A specific type of ischemia induced ventricular arrhythmia is reperfusion arrhythmia, which is triggered by reperfusion of ischemic myocardium. In the clinical milieu it is most frequent during thrombolytic therapy and during coronary interventions. Ventricular fibrillation is the most frequent type of arrhythmia in the acute phase of myocardial infarction. Besides several described triggering mechanisms, an increase in catecholamines is very important for its initiation and support. Besides VF, in acute myocardial infarction several bradyarrhythmias and special type of arrhythmia known as electro mechanic dissociation are important. Ischemias in the acute phase are treated by immediate VF defibrillation followed by medical therapy in hospital. Besides lidocaine, several other antiarrhythmics, such as bretylium, beta blockers and amiodarone, and the prevention of electrolytic disequilibrium can be used. In addition to the use of antiarrhythmic therapy, the use of implantable cardioverter defibrillator is a feasible therapy and superior to medical treatment and could be used as primary and secondary prevention of sudden cardiac death in special clinical situations and in special described groups of patients.
Deskriptorji		CORONARY DISEASE ARRHYTHMIA DEATH, SUDDEN, CARDIAC