Клиническое значение наджелудочковой экстрасистолии и подходы к ее лечению
https://doi.org/10.35336/VA-1436
EDN: RWJYHQ
Аннотация
Наджелудочковые экстрасистолы (НЖЭ) являются распространенным явлением в общей популяции. Ранее НЖЭ считалась безопасной электрокардиографической находкой, не имеющей большого клинического значения. Однако, накапливается все больше данных, свидетельствующих о положительной связи между частотой НЖЭ и риском развития фибрилляции предсердий, ишемического инсульта или транзиторной ишемической атаки, а также смертностью от всех причин. В связи с этим, становятся актуальны проблемы определения клинической значимости НЖЭ и тактики ведения таких больных.
Об авторах
А. М. Баймуканов
Государственное бюджетное учреждение здравоохранения «Городская клиническая больница имени В.М. Буянова Департамента здравоохранения города Москвы
Россия
Россия
Москва, Бакинская, д. 26
Е. И. Котляревская
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» МЗ РФ
Россия
Россия
Котляревская Елизавета Игоревна.
Москва, ул. Островитянова, д. 1
А. В. Мелехов
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» МЗ РФ
Россия
Россия
Москва, ул. Островитянова, д. 1
Г. Е. Гендлин
ФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» МЗ РФ
Россия
Россия
Москва, ул. Островитянова, д. 1
Список литературы
1. Conen D, Adam M, Roche F, et al. Premature Atrial Contractions in the General Population. Circulation. 2012;126(19): 2302-2308. https://doi.org/10.1161/CIRCULATIONAHA.112.112300.
2. Затонская ЕВ, Матюшин ГВ, Гоголашвили НГ, и др. Частота гетеротопных аритмий в популяции взрослого населения Заполярья. Сибирское медицинское обозрение. 2015;(4): 52-56. https://doi.org/10.20333/25000136-2015-4-52-56.
3. Тихоненко ВМ, Тулинцева ТЭ, Лышова ОВ, и др. Нарушения ритма и проводимости сердца у здоровых лиц. Вестник аритмологии. 2018;(91): 11-20.
4. Berisso MZ, Ferroni A, De Caro E, Carratino L, et al Clinical significance of supraventricular tachyarrhythmias after acute myocardial infarction. Eur Heart J. 1986;7(9): 743-748. https://doi.org/10.1093/oxfordjournals.eurheartj.a062135.
5. Kawano Y, Tamura A, Ono K, Kadota J. Association between obstructive sleep apnea and premature supraventricular contractions. J Cardiol. 2014;63(1): 69-72. https://doi.org/10.1016/j.jjcc.2013.07.003.
6. Kusunoki Y, Nakamura T, Hattori K, et al.Atrial and Ventricular Arrhythmia-Associated Factors in Stable Patients with Chronic Obstructive Pulmonary Disease. Respiration. 2016;91(1): 34-42. https://doi.org/10.1159/000442447.
7. Huang B, Huang F, Peng Y, et al. Relation of premature atrial complexes with stroke and death: Systematic review and meta‐analysis. Clin Cardiol. 2017;40(11): 962-969. https://doi.org/10.1002/clc.22780.
8. Himmelreich JCL, Lucassen WAM, Heugen M, et al. Frequent premature atrial contractions are associated with atrial fibrillation, brain ischaemia, and mortality: a systematic review and meta-analysis. Europace. 2019;21(5): 698-707. https://doi.org/10.1093/europace/euy276.
9. Meng L, Tsiaousis G, He J, et al. Excessive Supraventricular Ectopic Activity and Adverse Cardiovascular Outcomes: a Systematic Review and Meta-analysis. Curr Atheroscler Rep. 2020;22(4): 14. https://doi.org/10.1007/s11883-020-0832-4.
10. Goette A, Kalman JM, Aguinaga L, et al. EHRA/HRS/ APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Europace. 2016;18(10): 1455-1490. https://doi.org/10.1093/europace/euw161.
11. Arnar DO, Mairesse GH, Boriani G, et al. Management of asymptomatic arrhythmias: a European Heart Rhythm Association (EHRA) consensus document, endorsed by the Heart Failure Association (HFA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), Cardiac Arrhythmia Society of Southern Africa (CASSA), and Latin America Heart Rhythm Society (LAHRS). EP Europace. 2019;21(6): 844-845. https://doi.org/10.1093/europace/euz046.
12. Kamel H, Okin PM, Elkind MSV, Iadecola C. Atrial Fibrillation and Mechanisms of Stroke. Stroke. 2016;47(3): 895-900. https://doi.org/10.1161/STROKEAHA.115.012004.
13. Ahlberg G, Refsgaard L, Lundegaard PR, et al. Rare truncating variants in the sarcomeric protein titin associate with familial and early-onset atrial fibrillation. Nat Commun. 2018;9(1): 4316. https://doi.org/10.1038/s41467-018-06618-y.
14. Nattel S. Close connections between contraction and rhythm: a new genetic cause of atrial fibrillation/cardiomyopathy and what it can teach us. Eur Heart J. 2017;38(1): 35-37. https://doi.org/10.1093/eurheartj/ehw457.
15. Murakoshi N, Xu D, Sairenchi T, et al. Prognostic impact of supraventricular premature complexes in community-based health checkups: The Ibaraki Prefectural Health Study. Eur Heart J. 2015;36(3): 170-178. https://doi.org/10.1093/eurheartj/ehu407.
16. Shimada Y, Todo K, Doijiri R, et al. Higher Frequency of Premature Atrial Contractions Correlates With Atrial Fibrillation Detection after Cryptogenic Stroke. Stroke. 2024;55(4): 946-953. https://doi.org/10.1161/STROKEAHA.123.044813.
17. Sasaki K, Nakajima I, Higuma T, et al. Revisit to the Prognostic Value of Premature Atrial Contraction Burden in 24-h Holter Electrocardiography for Predicting Undiagnosed Atrial Fibrillation A Propensity Score-Matched Study. Circulation Journal. 2021;85(8): CJ-20-1277. https://doi.org/10.1253/circj.CJ-20-1277.
18. Prasitlumkum N, Rattanawong P, Limpruttidham N, et al. Frequent premature atrial complexes as a predictor of atrial fibrillation: Systematic review and meta-analysis. J Electrocardiol. 2018;51(5): 760-767. https://doi.org/10.1016/j.jelectrocard.2018.05.012.
19. Acharya T, Tringali S, Bhullar M, et al. Frequent Atrial Premature Complexes and Their Association With Risk of Atrial Fibrillation. Am J Cardiol. 2015;116(12): 1852-1857. https://doi.org/10.1016/j.amjcard.2015.09.025.
20. Chong BH, Pong V, Lam KF, et al. Frequent premature atrial complexes predict new occurrence of atrial fibrillation and adverse cardiovascular events. Europace. 2012;14(7): 942-947. https://doi.org/10.1093/europace/eur389.
21. Suzuki S, Sagara K, Otsuka T, et al. Usefulness of Frequent Supraventricular Extrasystoles and a High CHADS2 Score to Predict First-Time Appearance of Atrial Fibrillation. Am J Cardiol. 2013;111(11): 1602-1607. https://doi.org/10.1016/j.amjcard.2013.01.335.
22. Gladstone DJ, Dorian P, Spring M, et al. Atrial Premature Beats Predict Atrial Fibrillation in Cryptogenic Stroke. Stroke. 2015;46(4): 936-941. https://doi.org/10.1161/STROKEAHA.115.008714.
23. Binici Z, Intzilakis T, Nielsen OW, Køber L, et al. Excessive Supraventricular Ectopic Activity and Increased Risk of Atrial Fibrillation and Stroke. Circulation. 2010;121(17): 1904-1911. https://doi.org/10.1161/CIRCULATIONAHA.109.874982.
24. Larsen BS, Kumarathurai P, Falkenberg J, et al. Excessive Atrial Ectopy and Short Atrial Runs Increase the Risk of Stroke Beyond Incident Atrial Fibrillation. J Am Coll Cardiol. 2015;66(3): 232-241. https://doi.org/10.1016/j.jacc.2015.05.018.
25. Yang M, Lin Y, Cheng H, et al. Excessive Supraventricular Ectopic Activity and the Risk of Atrial Fibrillation and Stroke: A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis. 2022;9(12): 461. https://doi.org/10.3390/jcdd9120461.
26. Todo K, Moriwaki H, Saito K, Naritomi H. Frequent Premature Atrial Contractions in Stroke of Undetermined Etiology. Eur Neurol. 2009;61(5): 285-288. https://doi.org/10.1159/000206853.
27. Liuba I, Schaller RD, Frankel DS. Premature atrial complex-induced cardiomyopathy: Case report and literature review. HeartRhythm Case Rep. 2020;6(4): 191-193. https://doi.org/10.1016/j.hrcr.2019.12.010.
28. Hasdemir C, Simsek E, Yuksel A. Premature atrial contraction-induced cardiomyopathy. EP Europace. 2013;15(12): 1790-1790. https://doi.org/10.1093/europace/eut141.
29. Vervueren PL, Delmas C, Berry M, et al. Reversal of Dilated Cardiomyopathy After Successful Radio-Frequency Ablation of Frequent Atrial Premature Beats, a New Cause for Arrhythmia-Induced Cardiomyopathy. J Atr Fibrillation. 2012;5(4): 627. https://doi.org/10.4022/jafib.627.
30. Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5): 655-720. https://doi.org/10.1093/eurheartj/ehz467.
31. Dan GA, Martinez-Rubio A, Agewall S, et al. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and International Society of Cardiovascular Pharmacotherapy (ISCP). Europace. 2018;20(5): 731-732an. https://doi.org/10.1093/europace/eux373.
32. Christiansen E, Frost L, Andreasen F, et al. Dose-related cardiac electrophysiological effects of intravenous magnesium. A double-blind placebo-controlled dose-response study in patients with paroxysmal supraventricular tachycardia. Europace. 2000;2(4): 320-326. https://doi.org/10.1053/eupc.2000.0123.
33. Rasmussen HS, Thomsen PEB. The electrophysiological effects of intravenous magnesium on human sinus node, atrioventricular node, atrium, and ventricle. Clin Cardiol. 1989;12(2): 85-90. https://doi.org/10.1002/clc.4960120204.
34. Kulick DL, Hong R, Ryzen E, et al. Electrophysiologic effects of intravenous magnesium in patients with normal conduction systems and no clinical evidence of significant cardiac disease. Am Heart J. 1988;115(2): 367-373. https://doi.org/10.1016/0002-8703(88)90483-8.
35. Falco CNML De, Grupi C, Sosa E, et al. Redução da densidade de extrassístoles e dos sintomas relacionados após administração de magnésio por via oral. Arq Bras Cardiol. 2012;98(6): 480-487. https://doi.org/10.1590/S0066-782X2012005000043.
36. Falco CNML De, Darrieux FC da C, Grupi C, et al. Late Outcome of a Randomized Study on Oral Magnesium for Premature Complexes. Arq Bras Cardiol. 2014. https://doi.org/10.5935/abc.20140171.
37. Lutsey PL, Chen LY, Eaton A, et al. A Pilot Randomized Trial of Oral Magnesium Supplementation on Supraventricular Arrhythmias. Nutrients. 2018;10(7): 884. https://doi.org/10.3390/nu10070884
38. Рейнгардене ДИ, Азаравичене АП. Эффективность амиодарона (кордарона) при предсердной экстрасистолии. Терапевтический архив. 2004;9(6): 87-89.
39. Huang TC, Lee PT, Huang MS, et al. The Beneficial Effects of Beta Blockers on the Long-Term Prognosis of Patients With Premature Atrial Complexes. Front Cardiovasc Med. 2022;9. https://doi.org/10.3389/fcvm.2022.806743.
40. Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source. New England Journal of Medicine. 2018;378(23): 2191-2201. https://doi.org/10.1056/NEJMoa1802686.
41. Diener HC, Sacco RL, Easton JD, et al. Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. New England Journal of Medicine. 2019;380(20): 1906-1917. https://doi.org/10.1056/NEJMoa1813959.
42. Kamel H, Longstreth WT, Tirschwell DL, et al. Apixaban to Prevent Recurrence After Cryptogenic Stroke in Patients With Atrial Cardiopathy. JAMA. 2024;331(7): 573. https://doi.org/10.1001/jama.2023.27188.
43. Fuller H, Justo F, Nearing BD, et al. Eleclazine, a new selective cardiac late sodium current inhibitor, confers concurrent protection against autonomically induced atrial premature beats, repolarization alternans and heterogeneity, and atrial fibrillation in an intact porcine model. Heart Rhythm. 2016;13(8): 1679-1686. https://doi.org/10.1016/j.hrthm.2016.04.015.
44. Wang X, Li Z, Mao J, He B. Electrophysiological features and catheter ablation of symptomatic frequent premature atrial contractions. Europace. 2017;19(9): 1535-1541. https://doi.org/10.1093/europace/euw152.
45. Chen M, Yang M, Li W, et al. Novel dual-reference approach facilitates the activation mapping and catheter ablation of premature atrial complexes with non-pulmonary vein and non-superior vena cava origins. Europace. 2023;25(1): 146-155. https://doi.org/10.1093/europace/euac129.
46. Gagyi RB, Noten AME, Lesina K, et al. Single-beat global atrial mapping facilitates the treatment of short-lived atrial tachycardias and infrequent premature atrial contractions. Journal of Interventional Cardiac Electrophysiology. 2022;66(4): 951-959. https://doi.org/10.1007/s10840-022-01405-8.
47. Ip JE, Lerman BB. Deceptive Nature of Atrial Premature Contractions. Circulation. 2014;130(17). https://doi.org/10.1161/CIRCULATIONAHA.114.011155.
48. Dobran IJ, Niebch V, Vester EG. Successful radiofrequency catheter ablation of atrial trigeminy in a young patient. Heart. 1998;80(3): 301-302. https://doi.org/10.1136/hrt.80.3.301.
49. Yamada T, Murakami Y, Okada T, et al. Electroanatomic mapping in the catheter ablation of premature atrial contractions with a non-pulmonary vein origin. Europace. 2008;10(11): 1320-1324. https://doi.org/10.1093/europace/eun238.
50. Huang X, Chen Y, Xiao J, et al. Electrophysiological characteristics and catheter ablation of symptomatic focal premature atrial contractions originating from pulmonary veins and non‐pulmonary veins. Clin Cardiol. 2018;41(1): 74-80. https://doi.org/10.1002/clc.22853.
51. Bokeria LA, Golukhova EZ, Popov S V., et al. 2020 Clinical practice guidelines for Supraventricular tachycardia in adults. Russian Journal of Cardiology. 2021;26(5): 4484. https://doi.org/10.15829/1560-4071-2021-4484.
52. Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1). https://doi.org/10.1161/CIR.0000000000001193.
Рецензия
Для цитирования:
Баймуканов А.М., Котляревская Е.И., Мелехов А.В., Гендлин Г.Е. Клиническое значение наджелудочковой экстрасистолии и подходы к ее лечению. Вестник аритмологии. 2025;32(1):e6-e14. https://doi.org/10.35336/VA-1436. EDN: RWJYHQ
For citation:
Baimukanov A.M., Kotlyarevskaya E.I., Melekhov A.V., Gendlin G.E. Clinical significance of premature atrial contractions and approaches to its treatment. Journal of Arrhythmology. 2025;32(1):e6-e14. https://doi.org/10.35336/VA-1436. EDN: RWJYHQ
Просмотров:
1289
Послать статью по эл. почте 