Tom 14, Nr 5 (2017)
Zaburzenia rytmu serca
Opublikowany online: 2018-03-06
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657
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4659
Postępowanie w migotaniu przedsionków u pacjentów w podeszłym wieku
Choroby Serca i Naczyń 2017;14(5):248-257.
Streszczenie
Migotanie przedsionków jest jednym z najczęściej występujących zaburzeń rytmu serca. Stanowi niezależny czynnik ryzyka zgonu, jak i podstawę rozwoju i progresji innych schorzeń sercowo – naczyniowych. Ponad to pogarsza jakość życia, zarówno jako choroba zasadnicza, jak i ze względu na powikłania, do których prowadzi.
Częstość występowania migotania przedsionków wzrasta z wiekiem, co jest związane zarówno ze zmianami, jakie zachodzą w budowie serca, m.in. z włóknieniem oraz stłuszczeniem, jak i z częstszym występowaniem schorzeń będących podłożem dla wystąpienia arytmii, tj. wady zastawkowe czy niewydolność serca.
Pomimo tego, iż osoby w wieku podeszłym stanowią najliczniejszą i najbardziej narażoną na powikłania grupę chorych z migotaniem przedsionków, ich leczenie często nie jest optymalne. W wielu sytuacjach próbuje się forsować uzyskanie i utrzymanie rytmu zatokowego narażając pacjentów na procedury inwazyjne, czy farmakoterapię, które w ich przypadku mają ograniczoną skuteczność, z drugiej strony, z obawy przed powikłaniami krwotocznymi, nie włącza się leczenia przeciwzakrzepowego, mającego faktyczne znaczenie dla życia i sprawności chorych.
Słowa kluczowe: migotanie przedsionkówpacjenci w wieku podeszłymleczenie przeciwzakrzepowe
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