心脏复极储备异常与恶性室性心律失常

摘要

心脏复极异常可导致尖端扭转型室性心动过速和心脏性猝死.复极储备是心脏具有的内源性抗心律失常机制,可用来解释心脏复极异常的程度和心律失常发生的可能性.复极储备降低可发生在多种影响心肌细胞离子电流的病理状况和药物作用下,如各种因素导致外向电流降低和内向电流增加时,这些因素可导致恶性心律失常和心源性猝死的易感性增高.现总结心脏复极储备异常的发生机制及相关心律失常的预防和治疗.%Abnormalities of cardiac repolarization are associated with the development of lethal ventricular arrhythmias, including tor-sades de pointes ( TdP ) and sudden cardiac death. Cardiac repolarization reserve is an endogenous antiarrhythmic mechanism which can be used to explain the susceptibility of the heart to proarrhythmic risk factors. Many hereditary, pathological and pharmacological conditions may decrease the repolarization reserve by either reducing the outward currents or increasing the inward currents in the cardiac cells. This article summarized the mechanisms of the reduction of the repolarization reserve, and the prevention and the treatment of arrhythmias associated with the reduced repolarization reserve.