ВНЕЗАПНАЯ СЕРДЕЧНАЯ СМЕРТЬ: ОТ СТРАТИФИКАЦИИ РИСКА К ПРОФИЛАКТИКЕ
Аннотация
Статья посвящена проблеме прогнозирования риска и профилактике внезапной сердечной смерти (ВСС) в общей популяции людей и при заболеваниях сердца. Обсуждаются подходы к стратификации риска ВСС на популяционном и индивидуальном уровнях на основе клинических, инструментальных и генетических методов диагностики и скрининга. Рассматриваются превентивные и терапевтические стратегии в аспекте остановки сердечной деятельности и ВСС. Проблема определения индивидуального риска ВСС для лиц из числа общей популяции в настоящее время сложна и однозначно не решена. Стратификация риска желудочковых тахиаритмий и ВСС в группах пациентов высокого риска позволяет определить превентивную стратегию. Основой такой стратегии является использование имплантируемых кардиовертеров-дефибрилляторов. В популяции пациентов с сердечной недостаточностью использование оптимальной медикаментозной терапии позволяет снизить риск общей, сердечно-сосудистой и внезапной сердечной смерти. Раннее установление диагноза редких заболеваний (кардиомиопатий, каналопатий) позволит провести информирование о потенциальных триггерах желудочковых тахиаритмий, провести своевременное распознавание и подтверждение угрожающих жизни аритмий, стратификацию риска ВСС и определить превентивную стратегию лечения.
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