cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-2694cardiovascular-2694Research ArticleКЛИНИКА И ФАРМАКОТЕРАПИЯCLINIC AND PHARMACOTHERAPYСовременные принципы лечения наджелудочковых тахикардийModern treatment of supraventricular tachycardiahttps://orcid.org/0000-0001-9536-8307ТарзимановаА. И.TarzimanovaA. I.

Доктор медицинских наук, профессор кафедры факультетской терапии № 2 лечебного факультета.

Москва, Тел.: +7 (903) 621-00-75

Moscow

tarzimanova@mail.ruhttps://orcid.org/0000-0002-0758-5609ПодзолковВ. И.PodzolkovV. I.

Доктор медицинских наук, профессор, заведующий кафедрой.

Москва

Moscow

tarzimanova@mail.ruФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)I.M. Sechenov First Moscow State Medical University20201211202019526942694Copyright © Тарзиманова А.И., Подзолков В.И., 20202020Тарзиманова А.И., Подзолков В.И.Tarzimanova A.I., Podzolkov V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2694

Наджелудочковые тахикардии (НЖТ) относятся к числу наиболее распространенных нарушений сердечного ритма. Распространенность НЖТ широко варьирует в разных странах и составляет в общей популяции 2,25 на 1 тыс. человек. Их возникновение сопровождается ухудшением качества жизни пациентов, а в ряде случаев может ухудшить прогноз. У больных с сердечно-сосудистой патологией риск развития НЖТ возрастает. Купирующая терапия пароксизмов НЖТ осуществляется дифференцировано в зависимости от стабильности гемодинамических показателей и ширины комплексов QRS. До настоящего времени лечение НЖТ остается актуальным вопросом современной кардиологии, т.к. несмотря на большие возможности катетерной аблации, антиаритмическая терапия занимает важное место в купировании пароксизмов НЖТ и профилактике ее рецидивов.

Supraventricular tachycardia (SVT) is one of the most common arrhythmias. The prevalence of SVT varies widely in different countries and is 2,25 per 1,000 people in the general population. SVT reduce the quality of life of patients, and in some cases can worsen the prognosis. In patients with cardiovascular disease, the risk of SVT increases. Therapy of SVT is selected depending on the stability of hemodynamic and the QRS width. Until now, the treatment of SVT remains an urgent issue of modern cardiology, since despite the high effectiveness of catheter ablation, antiarrhythmic therapy plays an important role.

наджелудочковые тахикардиилечениеантиаритмическая терапияsupraventricular tachycardiatreatmentantiarrhythmic therapyReferencesBrugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5):655-720. doi:10.1093/eurheartj/ehz467Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5):655-720. doi:10.1093/eurheartj/ehz467Lu C-W, Wu M-H, Chen H-C, et al. Epidemiological profile of Wolff-Parkinson-White syndromeinageneralpopulationyoungerthan50yearsofageinaneraofradiofrequency catheter ablation. Int J Cardiol. 2014;174(3):530-4. doi:10.1016/j.ijcard.2014.04.134.Lu C-W, Wu M-H, Chen H-C, et al. Epidemiological profile of Wolff-Parkinson-White syndromeinageneralpopulationyoungerthan50yearsofageinaneraofradiofrequency catheter ablation. Int J Cardiol. 2014;174(3):530-4. doi:10.1016/j.ijcard.2014.04.134.Skov MW, Rasmussen PV, Ghouse J, et al Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality: Results From the Copenhagen ECG Study. Circ Arrhythm Electrophysiol. 2017;10(6):e004778. doi:10.1161/CIRCEP.116.004778.Skov MW, Rasmussen PV, Ghouse J, et al Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality: Results From the Copenhagen ECG Study. Circ Arrhythm Electrophysiol. 2017;10(6):e004778. doi:10.1161/CIRCEP.116.004778.Wittwer MR, Rajendran S, Kealley J, Arstall MA. A South Australian registry of biphasic cardioversions of atrial arrhythmias: efficacy and predictors of success. Heart Lung Circ. 2015;24(4):342-7 doi:10.1016/j.hlc.201410.004.Wittwer MR, Rajendran S, Kealley J, Arstall MA. A South Australian registry of biphasic cardioversions of atrial arrhythmias: efficacy and predictors of success. Heart Lung Circ. 2015;24(4):342-7 doi:10.1016/j.hlc.201410.004.Smith G, Taylor DM, Morgans A, Cameron P. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med. 2013;28(3):301-4. doi:10.1017/S1049023X13000174.Smith G, Taylor DM, Morgans A, Cameron P. Prehospital synchronized electrical cardioversion of a poorly perfused SVT patient by paramedics. Prehosp Disaster Med. 2013;28(3):301-4. doi:10.1017/S1049023X13000174.Alabed S, Sabouni A, Providencia R, et al. Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Cochrane Database Syst Rev. 2017;10(10):CD005154. doi:10.1002/14651858.CD005154.pub4.Alabed S, Sabouni A, Providencia R, et al. Adenosine versus intravenous calcium channel antagonists for supraventricular tachycardia. Cochrane Database Syst Rev. 2017;10(10):CD005154. doi:10.1002/14651858.CD005154.pub4.Lim SH, Anantharaman V, Teo WS, Chan YH. Slow infusion of calcium channel blockers compared with intravenous adenosine in the emergency treatment of supraventricular tachycardia. Resuscitation. 2009;80:523-8. doi:10.1016/j.resuscitation.2009.01.017.Lim SH, Anantharaman V, Teo WS, Chan YH. Slow infusion of calcium channel blockers compared with intravenous adenosine in the emergency treatment of supraventricular tachycardia. Resuscitation. 2009;80:523-8. doi:10.1016/j.resuscitation.2009.01.017.Das G, Tschida V, Gray R, et al. Efficacy of esmolol in the treatment and transfer of patients with supraventricular tachyarrhythmias to alternate oral antiarrhythmic agents. J Clin Pharmacol. 1988;28:746-50. doi:10.1002/j.1552-4604.1988.tb03209.x.Das G, Tschida V, Gray R, et al. Efficacy of esmolol in the treatment and transfer of patients with supraventricular tachyarrhythmias to alternate oral antiarrhythmic agents. J Clin Pharmacol. 1988;28:746-50. doi:10.1002/j.1552-4604.1988.tb03209.x.Li N, Csepe TA, Hansen BJ, et al. Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016;134(6):486-98. doi:10.1161/aRCULATIONAHA.115.021165.Li N, Csepe TA, Hansen BJ, et al. Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016;134(6):486-98. doi:10.1161/aRCULATIONAHA.115.021165.Ptaszynski P, Kaczmarek K, Ruta J, et al. Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy. Europace. 2013;15:116-21. doi:10.1093/europace/eus204.Ptaszynski P, Kaczmarek K, Ruta J, et al. Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy. Europace. 2013;15:116-21. doi:10.1093/europace/eus204.Benezet-Mazuecos J, Rubio JM, Farr EJ, et al. Long-term outcomes of ivabradine in inappropriate sinus tachycardia patients: appropriate efficacy or inappropriate patients. Pacing Clin Electrophysiol. 2013;36:830-36. doi:10.1111/pace.12118.Benezet-Mazuecos J, Rubio JM, Farr EJ, et al. Long-term outcomes of ivabradine in inappropriate sinus tachycardia patients: appropriate efficacy or inappropriate patients. Pacing Clin Electrophysiol. 2013;36:830-36. doi:10.1111/pace.12118.Calo L, Rebecchi M, Sette A, et al. Efficacy of ivabradine administration in patients affected by inappropriate sinus tachycardia. Heart Rhythm. 2010;7:1318-23. doi:10.1016/j.hrthm.2010.05.034.Calo L, Rebecchi M, Sette A, et al. Efficacy of ivabradine administration in patients affected by inappropriate sinus tachycardia. Heart Rhythm. 2010;7:1318-23. doi:10.1016/j.hrthm.2010.05.034.Jacobson JT, Kraus A, Lee R, et al. Epicardial/endocardial sinus node ablation after failed endocardial ablation for the treatment of inappropriate sinus tachycardia. J Cardiovasc Electrophysiol. 2014;25:236-41. doi:10.1111/jce.12318.Jacobson JT, Kraus A, Lee R, et al. Epicardial/endocardial sinus node ablation after failed endocardial ablation for the treatment of inappropriate sinus tachycardia. J Cardiovasc Electrophysiol. 2014;25:236-41. doi:10.1111/jce.12318.Raj SR, Biaggioni I, Yamhure PC, et al. Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome. Circulation. 2005;111:1574-82. doi:10.1161/01.CIR.0000160356.97313.5D.Raj SR, Biaggioni I, Yamhure PC, et al. Renin-aldosterone paradox and perturbed blood volume regulation underlying postural tachycardia syndrome. Circulation. 2005;111:1574-82. doi:10.1161/01.CIR.0000160356.97313.5D.Medi C, Kalman JM, Haqqani H, et al. Tachycardia-mediated cardiomyopathy secondary to focal atrial tachycardia: long-term outcome after catheter ablation. J Am Coll Cardiol. 2009;53:1791-7 doi:10.1016/j.jacc.2009.02.014.Medi C, Kalman JM, Haqqani H, et al. Tachycardia-mediated cardiomyopathy secondary to focal atrial tachycardia: long-term outcome after catheter ablation. J Am Coll Cardiol. 2009;53:1791-7 doi:10.1016/j.jacc.2009.02.014.Chen SA, Chiang CE, Yang CJ, et al Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation.1994;90:1262-78. doi:10.1161/01.cir.90.3.1262.Chen SA, Chiang CE, Yang CJ, et al Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation.1994;90:1262-78. doi:10.1161/01.cir.90.3.1262.Hohnloser SH, Zabel M. Short- and long-term efficacy and safety of flecainide acetate for supraventricular arrhythmias. Am J Cardiol. 1992;70(5):3A-9A; discussion 9A-10A. doi:10.1016/0002-9149(92)91071-b.Hohnloser SH, Zabel M. Short- and long-term efficacy and safety of flecainide acetate for supraventricular arrhythmias. Am J Cardiol. 1992;70(5):3A-9A; discussion 9A-10A. doi:10.1016/0002-9149(92)91071-b.Stoschitzky K, Stoschitzky G, Lercher P, et al. Propafenone shows class Ic and class II antiarrhythmic effects. Europace. 2016;18(4):568-71. doi:10.1093/europace/euv195.Stoschitzky K, Stoschitzky G, Lercher P, et al. Propafenone shows class Ic and class II antiarrhythmic effects. Europace. 2016;18(4):568-71. doi:10.1093/europace/euv195.Heush A, Kramer HH, Krogmann ON, et al. Clinical experience with propafenone for cardiac arrhythmias in the young. Eur Heart J. 1994;15:1050-6. doi:10.1093/oxfordjournals.eurheartj.a060627.Heush A, Kramer HH, Krogmann ON, et al. Clinical experience with propafenone for cardiac arrhythmias in the young. Eur Heart J. 1994;15:1050-6. doi:10.1093/oxfordjournals.eurheartj.a060627.Bunin YA, Miklishanskaya SA, Zolozova EA, Chigineva W. Atrial Tachyarrhythmias and Atrial Flutter: the Basics of Diagnostics and Modern Opportunities of Therapy. Rational Pharmacotherapy in Cardiology. 2019;15(1):115-24. (In Russ.) doi:10.20996/1819-6446-2019-15-1-115-124.Bunin YA, Miklishanskaya SA, Zolozova EA, Chigineva W. Atrial Tachyarrhythmias and Atrial Flutter: the Basics of Diagnostics and Modern Opportunities of Therapy. Rational Pharmacotherapy in Cardiology. 2019;15(1):115-24. (In Russ.) doi:10.20996/1819-6446-2019-15-1-115-124.Reimold SC, Maisel WH, Antman EM. Propafenone for the treatment of supraventricular tachycardia and atrial fibrillation: a meta-analysis. Am J Cardiol. 1998;82(8A):66N-71N. doi:10.1016/s0002-9149(98)00587-6.Reimold SC, Maisel WH, Antman EM. Propafenone for the treatment of supraventricular tachycardia and atrial fibrillation: a meta-analysis. Am J Cardiol. 1998;82(8A):66N-71N. doi:10.1016/s0002-9149(98)00587-6.Podzolkov VI, Tarzimanova AI. Antiarrhythmic therapy in the treatment of atrial fibrillation: yesterday, today, tomorrow. Cardiovascular Therapy and Prevention. 2019;18(3):81-7 (In Russ.) doi:10.15829/1728-8800-2019-3-81-87.Podzolkov VI, Tarzimanova AI. Antiarrhythmic therapy in the treatment of atrial fibrillation: yesterday, today, tomorrow. Cardiovascular Therapy and Prevention. 2019;18(3):81-7 (In Russ.) doi:10.15829/1728-8800-2019-3-81-87.Steinbeck G, Sinner MF, Lutz M, et al. Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: a nationwide in-hospital analysis of administrative data for Germany in 2014. Eur Heart J. 2018;39:4020-9. doi:10.1093/eurheartj/ehy452.Steinbeck G, Sinner MF, Lutz M, et al. Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: a nationwide in-hospital analysis of administrative data for Germany in 2014. Eur Heart J. 2018;39:4020-9. doi:10.1093/eurheartj/ehy452.Ghali WA, Wasil BI, Brant R, et al. Atrial flutter and the risk of thromboembolism: a systematic review and meta-analysis. Am J Med. 2005;118:101-7. doi: 10.1016/j.amjmed.2004.06.048.Ghali WA, Wasil BI, Brant R, et al. Atrial flutter and the risk of thromboembolism: a systematic review and meta-analysis. Am J Med. 2005;118:101-7. doi: 10.1016/j.amjmed.2004.06.048.Page RL, Joglar JA, Caldwell MA, 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. 2015;133:e506-74. doi:10.1161/CIR.0000000000000311.Page RL, Joglar JA, Caldwell MA, 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. 2015;133:e506-74. doi:10.1161/CIR.0000000000000311.Katritsis DG, Boriani G, Cosio FG, et al. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE). Europace. 2017;19:465-511. doi:10.1093/europace/euw301.Katritsis DG, Boriani G, Cosio FG, et al. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE). Europace. 2017;19:465-511. doi:10.1093/europace/euw301.Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893-962. doi:10.1093/eurheartj/ehw210.Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893-962. doi:10.1093/eurheartj/ehw210.Bunin YA, Denisov ON, Fedyakina LF. Preventive antiarrhythmic pharmacotherapy of frequent paroxysms of atrial fibrillation and some types of supraventricular tachycardia with propafenone in comparison with placebo. Russian Journal of Cardiology. 2010;(5):77-82. (In Russ.)Bunin YA, Denisov ON, Fedyakina LF. Preventive antiarrhythmic pharmacotherapy of frequent paroxysms of atrial fibrillation and some types of supraventricular tachycardia with propafenone in comparison with placebo. Russian Journal of Cardiology. 2010;(5):77-82. (In Russ.)Sorbo MD, Buja GF, Miorelli M, et al. The prevalence of the Wolff-Parkinson-White syndrome in a population of 116,542 young males. G Ital Cardiol. 1995;25(6):681-7Sorbo MD, Buja GF, Miorelli M, et al. The prevalence of the Wolff-Parkinson-White syndrome in a population of 116,542 young males. G Ital Cardiol. 1995;25(6):681-7Pappone C, Vicedomini G, Manguso F, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130:811-9. doi:10.1161/CIRCULATIONAHA.114.011154.Pappone C, Vicedomini G, Manguso F, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130:811-9. doi:10.1161/CIRCULATIONAHA.114.011154.

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