Профессия – кардиолог | United States America (US)

Create: 2024-05-08 Update: 2024-06-06 23:42:51

Лечение СУИQT

Согласно действующим клиническим рекомендациям:

✔️ Пациентам с СУИQT для профилактики ВСС рекомендован приём бета-адреноблокаторов.

✔️ Назначение бета-адреноблокаторов для профилактики ВСС также рекомендовано у носителей генетической мутации LQTS с нормальным QT-интервалом.

✔️ Внутривенное введение магния сульфата рекомендовано для предупреждения рецидивов полиморфной ЖТ типа torsade de pointes.

✔️ Временная электрокардиостимуляция с частотой 100 и больше в минуту рекомендуется для укорочения интервала QT и предупреждения рецидивов полиморфной ЖТ типа torsade de
pointes при отсутствии эффекта от введения магния сульфата.

✔️ Имплантация ИКД в сочетании с приёмом бета-адреноблокаторов рекомендована пациентам с СУИQT:
❤️пережившим остановку сердца;
❤️имеющим синкопальные состояния и/или ЖТ на фоне приёма адекватной дозы бета-адреноблокаторов;
❤️асимптомным носителям патологической мутации в генах KCNH2 или SCN5A при увеличении QTc > 500 мс.

✔️ Лечение ранолазином (45 мг/ч в течение 3 часов, затем 90 мг/ч в течение 5 часов) может быть рекомендовано в качестве дополнительной терапии с целью уменьшения длительности интервала QT у пациентов с СУИQT 3-го типа и QTc > 500 мс.

✔️ Выполнение грудной левосторонней симпатической денервации сердца рекомендовано у
симптомных пациентов с СУИQT в следующих случаях:
❤️приём бета-адреноблокаторов неэффективен, плохо переносится, либо имеются противопоказания;
❤️ИКД-терапия противопоказана или имеется отказ пациента;
❤️пациенты с имплантированным ИКД на фоне приёма бета-адреноблокаторов продолжают испытывать множественные разряды дефибриллятора.

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Лечение СУИQT

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