Sekundarna prevencija nagle srčane smrti

master's thesis

• Title (english): Secondary prevention of sudden cardiac death
• Author: Katarina Gojsalić
• Mentor: Martina Lovrić Benčić (mentor)
• Committee member: Davor Puljević (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Nagla srčana smrt (NSS) definira se kao neočekivana smrt kardiogenog podrijetla koja nastupa unutar jednog sata od početka simptoma kod osoba s ili bez prethodno prisutne bolesti srca, a najčešći mehanizam je srčana aritmija. U većini slučajeva javlja se u bolesnika sa strukturnom bolesti srca; koronarna srčana bolest je najčešći uzrok srčanog zastoja u odrasloj populaciji, odgovorna za do 80% slučajeva. Godišnja incidencija nagle srčane smrti u SAD-u se procijenjuje na oko 300.000 slučajeva. Unatoč brojnim naporima posljednih godina prevencija nagle srčane smrti i dalje ostaje izazov u suvremenoj kardiologiji. Strategije za predviđanje i sprječavanje NSS-a dijele se na primarne i sekundarne. Sekundarna prevencija se odnosi na mjere poduzete kako bi se smanjio rizik od NSS-a u bolesnika koji su već doživjeli abortirani srčani zastoj ili životno ugrožavajuće aritmije. Ugradbeni kardioverterski defibrilator (eng. implantable cardioverter defibrillator, ICD) je terapija prvog izbora za sve preživjele nakon srčanog zastoja, ako aritmija nije uzrokovana reverzibilnim čimbenicima (npr. akutni infarkt miokarda, proaritmički učinak lijekova ili elektrolitni poremećaji). Sve randomizirane studije sekundarne prevencije NSS-a pokazale su da je liječenje ICD-om učinkovitije u odnosu na terapiju s antiaritmičkim lijekovima. Bolesnici s ICD-om, koji imaju učestale recidive aritmija i aktivacije uređaja mogu imati koristi od dodatne terapije kao što su antiaritmički lijekovi ili liječenja kateterskom ablacijom.

Abstract (english)

Sudden cardiac death (SCD) is generally defined as unexpected death as the result of cardiovascular causes in a person with or without preexisting heart disease, usually due to a cardiac arrhythmia occurring within an hour of the onset of symptoms. In most cases it occurs in patients with structural heart disease; coronary artery disease is the most frequent cause of cardiac arrest, responsible for up to 80% cases. An estimated annual incidence of SCD is 300,000 cases per year in the US. Despite numerous efforts in recent years, preventing sudden cardiac death still remains a challenge in modern cardiology. Strategies for predicting and preventing SCD are classified as primary and secondary. Secondary prevention refers to measures taken to reduce the risk of SCD in patients who have already experienced an aborted cardiac arrest or life-threatening arrhythmias. Implantable cardioverter defibrillators (ICD) are the preferred therapy for survivors of cardiac arrest when the arrhythmia was not due to reversible factors (such as acute MI, proarrhythmic drug effects, or electrolyte disturbances). All randomised secondary prevention of sudden death trials have shown that ICD therapy is superior to antiarrhythmic drug therapy. Patients with ICDs, who have frequent arrhytmia recurrences and device discharges may benefit from adjunctive therapies, such as antiarrhythmic drugs or catheter ablation.

• Keywords: nagla srčana smrt; sekundarna prevencija; ICD
• Keywords (english): sudden cardiac death; secondary prevention; ICD
• Language: croatian
• URN:NBN: urn:nbn:hr:105:977387
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-14 08:24:24