rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2010-6-6-870-875rpcardio-934Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИTHE POSSIBILITIES OF ANTIARRHYTHMIC THERAPY IN PRIMARY PREVENTION OF DEATH IN PATIENTS WITH VENTRICULAR ARRHYTHMIASВОЗМОЖНОСТИ АНТИАРИТМИЧЕСКОЙ ТЕРАПИИ В ПЕРВИЧНОЙ ПРОФИЛАКТИКЕ СМЕРТИ У БОЛЬНЫХ С ЖЕЛУДОЧКОВЫМИ АРИТМИЯМИБунинЮ. А.BuninYu. A.

д.м.н., профессор кафедры кардиологии 

Российская медицинская академия последипломного образования

Barrikadnaya ul. 2/1, Moscow, 123995

yabunin@rol.ru123995, Москва, ул. Баррикадная, д. 2/1РоссияRussian Medical Academy of Postgraduate EducationRussian Federation20102101201666870875Copyright © Bunin Y.A., 20162016Бунин Ю.А.Bunin Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/934

Highlights of primary prevention of death in patients with ventricular arrhythmias (VA) are discussed. Overview of all main clinical trials exploring various anti-arrhythmic drugs in prevention of death in patients with VA is presented. It is emphasized that in patients with organic heart disease and VA only beta-blockers and amiodarone are able to reduce mortality, while other drugs have no effect on mortality, or they even increase mortality mainly due to arrhythmogenic effect. Recent clinical studies of the cardioverter-defibrillators efficacy in these patients are presented. It is shown that the use of cardioverter defibrillators compared with pharmacotherapy is more effective in prevention of fatal outcomes.

Рассматриваются актуальные вопросы первичной профилактики смерти у больных с желудочковыми аритмиями (ЖА). Приведён обзор всех основных клинических исследований, посвящённых изучению возможностей различных антиаритмических препаратов в профилактике смерти у больных с ЖА. Подчёркивается, что у больных с органическими заболеваниями сердца и ЖА только бета-блокаторы и амиодарон могут привести к снижению смертности, тогда как применение других препаратов либо не влияет на смертность, либо даже увеличивает летальность в основном за счёт аритмогенного эффекта. Представлены данные последних клинических исследований, посвящённых эффективности применения кардиовертеров-дефибрилляторов у рассматриваемой категории больных. Показано, что применение кардиовертеров-дефибрилляторов в сравнении с медикаментозной терапией имеет большую эффективность в профилактике смертельных исходов.

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The authors declare that there are no conflicts of interest present.