TAHIKARDIJOM INDUKOVANA KARDIOMIOPATIJA KAO POTENCIJALNO REVERZIBILNI UZROK SRČANE SLABOSTI

Vladan Kovačević

doi:10.5937/mp74-44291

vladan_kovacevic Univerzitetski klinički centar Srbije, Klinika za kardiologiju, Beograd, Srbija

DOI: https://doi.org/10.5937/mp74-44291

Ključne reči: tahikardijom indukovana kardiomiopatija, srčana insuficijencija, atrijalna fibrilacija, atrijalni flater, kateterska ablacija

Sažetak

Poremećaji srčanog ritma često se javljaju udruženo sa srčanom insuficijencijom i mogu biti njen uzrok ili posledica. Tahikardijom indukovana kardiomiopatija najčešće nastaje kao posledica perzistentnih atrijalnih tahiaritmija kao što su atrijalna fibrilacija i atrijalni flater. Ubrzana srčana frekvenca dovodi do sistolne i dijastolne disfunkcije leve komore sa njenom posledičnom dilatacijom uz promene na neurohumoralnom i celularnom nivou. Klinička slika varira od asimptomatskih tahikardija do terminalne srčane slabosti. Tahikardijom indukovana kardiomiopatija predstavlja često neprepoznat, a potencijalno reverzibilan uzrok srčane slabosti. Tačnu prevalencu tahikardiomiopatije je teško utvrditi jer se dijagnoza postavlja retrospektivno, na osnovu ehokardiografski potvrđenog oporavka funkcije leve komore nakon adekvatnog lečenja aritmije. Najefikasniji način lečenja je kateterska ablacija aritmije, a mogu se primeniti i električna kardioverzija, medikamentna kontrola ritma i/ili srčane frekvence i ugradnja pejsmejkera uz ablaciju atrioventrikularnog čvora.

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