СИНДРОМ СЛАБОСТИ СИНУСОВОГО УЗЛА
Аннотация
В лекции представлены современные данные, касающиеся одного из распространенных заболеваний проводящей системы сердца, сопряженного с высокой частотой нарушений ритма сердца, при котором наблюдается высокий риск внезапной сердечной смерти, – синдрома слабости синусового узла. Детально рассматриваются вопросы анатомии и физиологии синусового узла, понимание которых помогает своевременной диагностике и разработке необходимой тактики ведения пациентов с указанным заболеванием. Кратко приведены исторические сведения, касающиеся изучения этого состояния, его эпидемиология, этиология, патогенез. Подробно представлена классификация описываемого синдрома, рассмотрены его клинические проявления, дополнительные методы исследования. Детально освещены подходы лечения синдрома синусового узла, включая консервативное ведение пациентов, имплантацию электрокардиостимуляторов. Представлена информация, касающаяся прогноза таких пациентов.
Литература
1. Ватутин Н.Т., Скляная Е.В., Загоруйко А.Н., Гриценко Ю.П. Внезапная сердечная смерть. Часть 1. Факторы риска. Вестник неотложной и восстановительной хирургии. 2017; 2(4): 377-385.
2. Ватутин Н.Т., Тарадин Г.Г., Марон М.С., Шевелек А.Н. Внезапная сердечная смерть у больных гипертрофической кардиомиопатией. Кардиология. 2016; 1: 56-65 DOI: 10.18565/cardio.2016.1.56-651
3. Ватутин Н.Т., Калинкина Н.В., Скляная Е.В. и др. Синдромы в кардиологии. Донецк, «Каштан», 2010, 278 с.
4. Slotwiner D.J., Raitt M.H., Del-Carpio Munoz F., et al. Impact of physiologic versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: a systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidleines and the Heart Rhythm Society. Heart Rhythm. 2019 Sep;16(9):e280-e298. doi: 10.1016/j.hrthm.2018.10.035
5. Shen W.K., Sheldon R.S., Benditt D.G., et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136:e60-122. doi: 10.1161/CIR.0000000000000499
6. Page R.L., Joglar J.A., Caldwell M.A., et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133:e506-74. doi: 10.1161/CIR.0000000000000311
7. Ahmed H.M., Al-Mallah M.H., Keteyian S.J., et al. Sex-specific maximum predicted heart rate and its prognosis for mortality and myocardial infarction. Med Sci Sports Exerc. 2017;49:1704-10. doi: 10.1249/MSS.0000000000001285
8. Epstein A.E., DiMarco J.P., Ellenbogen K.A., et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2012;127:e283-352. doi: 10.1161/CIR.0b013e318276ce9b
9. Kusumoto F.M., Schoenfeld M.H., Barrett C., et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140:e333-e381. DOI: 10.1161/CIR.0000000000000627
10. Saremi F., Krishnan S. Cardiac conduction system: anatomic landmarks relevant to interventional electrophysiologic techniques demonstrated with 64-detector CT. Radiographics. 2007 Nov-Dec;27(6):1539-65; discussion 1566-7. doi: 10.1148/rg.276075003
11. Vikse J., Henry B.M., Roy J., et al. Anatomical variations in the sinoatrial nodal artery: a meta-analysis and clinical considerations. PLoS One. 2016 Feb 5;11(2):e0148331. doi: 10.1371/journal.pone.0148331.
12. DiFrancesco D., Noble D. A model of cardiac electrical activity incorporating ionic pumps and concentration changes. Philos Trans R Soc Lond B Biol Sci. 1985 Jan 10;307(1133):353-98. doi: 10.1098/rstb.1985.0001
13. Mezzano V., Liang Y., Wright A.T., et al. Desmosomal junctions are necessary for adult sinus node function. Cardiovasc Res. 2016;111:274-86. doi: 10.1093/cvr/cvw083
14. Dharod A., Soliman E.Z., Dawood F., et al. Association of asymptomatic bradycardia with incident cardiovascular disease and mortality: the multi-ethnic study of atherosclerosis (MESA). JAMA Intern Med. 2016;176:219-27. doi: 10.1001/jamainternmed.2015.7655
15. Nielsen J.C., Thomsen P.E., Hojberg S., et al. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome. Eur Heart J. 2011;32:686-96. doi: 10.1093/eurheartj/ehr022
16. AlJaroudi W.A., Alraies M.C., Wazni O., et al. Yield and diagnostic value of stress myocardial perfusion imaging in patients without known coronary artery disease presenting with syncope. Circ Cardiovasc Imaging. 2013;6:384-91. doi: 10.1161/CIRCIMAGING.112.000051
17. Steinberg J.S., Varma N., Cygankiewicz I., et al. 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry. Heart Rhythm. 2017;14:e55-e96. doi: 10.1016/j.hrthm.2017.03.038
18. Erne P., Iglesias J.F., Urban P., et al. Left bundle-branch block in patients with acute myocardial infarction: Presentation, treatment, and trends in outcome from 1997 to 2016 in routine clinical practice. Am Heart J. 2017;184:106-13. doi: 10.1016/j.ahj.2016.11.003
19. Chon S.B., Kwak Y.H., Hwang S.S., et al. Severe hyperkalemia can be detected immediately by quantitative electrocardiography and clinical history in patients with symptomatic or extreme bradycardia: a retrospective cross-sectional study. J Crit Care. 2013;28:1112.e7-13. doi: 10.1016/j.jcrc.2013.08.013
20. Wan D., Blakely C., Branscombe P., et al. Lyme carditis and high-degree atrioventricular block. Am J Cardiol. 2018;121:1102-4. doi: 10.1016/j.amjcard.2018.01.026
21. Ackerman M.J., Priori S.G., Willems S., et al. HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm. 2011;8:1308-39. doi: 10.1016/j.hrthm.2011.05.020
22. Jackson L.R. 2nd, Rathakrishnan B., Campbell K., et al. Sinus node dysfunction and atrial fibrillation: a reversible phenomenon? Pacing Clin Electrophysiol. 2017;40:442-50. doi: 10.1111/pace.13030
23. Peretto G., Durante A., Limite L.R., et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract. 2014;2014:615987. doi: 10.1155/2014/615987
24. Gee S.W., Karsies T.J. Listeria meningitis-associated bradyarrhythmia treated with isoproterenol. Am J Emerg Med. 2015;33:306.e1-2. doi: 10.1016/j.ajem.2014.06.022
25. Link M.S., Berkow L.C., Kudenchuk P.J., et al. Part 7: adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:Р444-64. doi: 10.1161/CIR.0000000000000261
26. Graudins A., Lee H.M., Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol. 2016;81:453-61. doi: 10.1111/bcp.12763
27. St-Onge M., Anseeuw K., Cantrell F.L., et al. Experts consensus recommendations for the management of calcium channel blocker Poisoning in Adults. Crit Care Med. 2017;45:e306-15. doi: 10.1097/CCM.0000000000002087
28. Roberts D.M., Gallapatthy G., Dunuwille A., et al. Pharmacological treatment of cardiac glycoside poisoning. Br J Clin Pharmacol. 2016;81:488-95. doi: 10.1111/bcp.12814
29. Gee S.W., Karsies T.J. Listeria meningitis-associated bradyarrhythmia treated with isoproterenol. Am J Emerg Med. 2015;33:306.e1-2. doi: 10.1016/j.ajem.2014.06.022
30. Muñoz Bono J., Prieto Palomino M.A., Macías Guarasa I., et al. Efficacy and safety of non-permanent transvenous pacemaker implantation in an intensive care unit. Medicina Intensiva (English Edition). 2011;35:410-6. doi: 10.1016/j.medin.2011.04.003
31. Bektas F., Soyuncu S. The efficacy of transcutaneous cardiac pacing in ED. Am J Emerg Med. 2016;34:2090-3. doi: 10.1016/j.ajem.2016.07.022
32. Al-Khatib S.M., Stevenson W.G., Ackerman M.J., et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2018;138:e272-391. doi: 10.1016/j.hrthm.2017.10.035
33. Yancy C.W., Jessup M., Bozkurt B., et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016;134:e282-93. doi: 10.1161/CIR.0000000000000435
2. Ватутин Н.Т., Тарадин Г.Г., Марон М.С., Шевелек А.Н. Внезапная сердечная смерть у больных гипертрофической кардиомиопатией. Кардиология. 2016; 1: 56-65 DOI: 10.18565/cardio.2016.1.56-651
3. Ватутин Н.Т., Калинкина Н.В., Скляная Е.В. и др. Синдромы в кардиологии. Донецк, «Каштан», 2010, 278 с.
4. Slotwiner D.J., Raitt M.H., Del-Carpio Munoz F., et al. Impact of physiologic versus right ventricular pacing among patients with left ventricular ejection fraction greater than 35%: a systematic review for the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidleines and the Heart Rhythm Society. Heart Rhythm. 2019 Sep;16(9):e280-e298. doi: 10.1016/j.hrthm.2018.10.035
5. Shen W.K., Sheldon R.S., Benditt D.G., et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136:e60-122. doi: 10.1161/CIR.0000000000000499
6. Page R.L., Joglar J.A., Caldwell M.A., et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133:e506-74. doi: 10.1161/CIR.0000000000000311
7. Ahmed H.M., Al-Mallah M.H., Keteyian S.J., et al. Sex-specific maximum predicted heart rate and its prognosis for mortality and myocardial infarction. Med Sci Sports Exerc. 2017;49:1704-10. doi: 10.1249/MSS.0000000000001285
8. Epstein A.E., DiMarco J.P., Ellenbogen K.A., et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2012;127:e283-352. doi: 10.1161/CIR.0b013e318276ce9b
9. Kusumoto F.M., Schoenfeld M.H., Barrett C., et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140:e333-e381. DOI: 10.1161/CIR.0000000000000627
10. Saremi F., Krishnan S. Cardiac conduction system: anatomic landmarks relevant to interventional electrophysiologic techniques demonstrated with 64-detector CT. Radiographics. 2007 Nov-Dec;27(6):1539-65; discussion 1566-7. doi: 10.1148/rg.276075003
11. Vikse J., Henry B.M., Roy J., et al. Anatomical variations in the sinoatrial nodal artery: a meta-analysis and clinical considerations. PLoS One. 2016 Feb 5;11(2):e0148331. doi: 10.1371/journal.pone.0148331.
12. DiFrancesco D., Noble D. A model of cardiac electrical activity incorporating ionic pumps and concentration changes. Philos Trans R Soc Lond B Biol Sci. 1985 Jan 10;307(1133):353-98. doi: 10.1098/rstb.1985.0001
13. Mezzano V., Liang Y., Wright A.T., et al. Desmosomal junctions are necessary for adult sinus node function. Cardiovasc Res. 2016;111:274-86. doi: 10.1093/cvr/cvw083
14. Dharod A., Soliman E.Z., Dawood F., et al. Association of asymptomatic bradycardia with incident cardiovascular disease and mortality: the multi-ethnic study of atherosclerosis (MESA). JAMA Intern Med. 2016;176:219-27. doi: 10.1001/jamainternmed.2015.7655
15. Nielsen J.C., Thomsen P.E., Hojberg S., et al. A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome. Eur Heart J. 2011;32:686-96. doi: 10.1093/eurheartj/ehr022
16. AlJaroudi W.A., Alraies M.C., Wazni O., et al. Yield and diagnostic value of stress myocardial perfusion imaging in patients without known coronary artery disease presenting with syncope. Circ Cardiovasc Imaging. 2013;6:384-91. doi: 10.1161/CIRCIMAGING.112.000051
17. Steinberg J.S., Varma N., Cygankiewicz I., et al. 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry. Heart Rhythm. 2017;14:e55-e96. doi: 10.1016/j.hrthm.2017.03.038
18. Erne P., Iglesias J.F., Urban P., et al. Left bundle-branch block in patients with acute myocardial infarction: Presentation, treatment, and trends in outcome from 1997 to 2016 in routine clinical practice. Am Heart J. 2017;184:106-13. doi: 10.1016/j.ahj.2016.11.003
19. Chon S.B., Kwak Y.H., Hwang S.S., et al. Severe hyperkalemia can be detected immediately by quantitative electrocardiography and clinical history in patients with symptomatic or extreme bradycardia: a retrospective cross-sectional study. J Crit Care. 2013;28:1112.e7-13. doi: 10.1016/j.jcrc.2013.08.013
20. Wan D., Blakely C., Branscombe P., et al. Lyme carditis and high-degree atrioventricular block. Am J Cardiol. 2018;121:1102-4. doi: 10.1016/j.amjcard.2018.01.026
21. Ackerman M.J., Priori S.G., Willems S., et al. HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm. 2011;8:1308-39. doi: 10.1016/j.hrthm.2011.05.020
22. Jackson L.R. 2nd, Rathakrishnan B., Campbell K., et al. Sinus node dysfunction and atrial fibrillation: a reversible phenomenon? Pacing Clin Electrophysiol. 2017;40:442-50. doi: 10.1111/pace.13030
23. Peretto G., Durante A., Limite L.R., et al. Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiol Res Pract. 2014;2014:615987. doi: 10.1155/2014/615987
24. Gee S.W., Karsies T.J. Listeria meningitis-associated bradyarrhythmia treated with isoproterenol. Am J Emerg Med. 2015;33:306.e1-2. doi: 10.1016/j.ajem.2014.06.022
25. Link M.S., Berkow L.C., Kudenchuk P.J., et al. Part 7: adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132:Р444-64. doi: 10.1161/CIR.0000000000000261
26. Graudins A., Lee H.M., Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol. 2016;81:453-61. doi: 10.1111/bcp.12763
27. St-Onge M., Anseeuw K., Cantrell F.L., et al. Experts consensus recommendations for the management of calcium channel blocker Poisoning in Adults. Crit Care Med. 2017;45:e306-15. doi: 10.1097/CCM.0000000000002087
28. Roberts D.M., Gallapatthy G., Dunuwille A., et al. Pharmacological treatment of cardiac glycoside poisoning. Br J Clin Pharmacol. 2016;81:488-95. doi: 10.1111/bcp.12814
29. Gee S.W., Karsies T.J. Listeria meningitis-associated bradyarrhythmia treated with isoproterenol. Am J Emerg Med. 2015;33:306.e1-2. doi: 10.1016/j.ajem.2014.06.022
30. Muñoz Bono J., Prieto Palomino M.A., Macías Guarasa I., et al. Efficacy and safety of non-permanent transvenous pacemaker implantation in an intensive care unit. Medicina Intensiva (English Edition). 2011;35:410-6. doi: 10.1016/j.medin.2011.04.003
31. Bektas F., Soyuncu S. The efficacy of transcutaneous cardiac pacing in ED. Am J Emerg Med. 2016;34:2090-3. doi: 10.1016/j.ajem.2016.07.022
32. Al-Khatib S.M., Stevenson W.G., Ackerman M.J., et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2018;138:e272-391. doi: 10.1016/j.hrthm.2017.10.035
33. Yancy C.W., Jessup M., Bozkurt B., et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016;134:e282-93. doi: 10.1161/CIR.0000000000000435
Опубликована
2020-12-01
Как цитировать
ВАТУТИН, Н. Т.; ТАРАДИН, Г. Г..
СИНДРОМ СЛАБОСТИ СИНУСОВОГО УЗЛА.
Университетская клиника, [S.l.], n. 4(37), p. 122-130, дек. 2020.
ISSN 1819-0464. Доступно на: <http://journal.dnmu.ru/index.php/UC/article/view/498>. Дата доступа: 27 апр. 2024
doi: https://doi.org/10.26435/uc.v0i4(37).498.
Раздел
Лекции
