Антиаритмические препараты: механизмы действия, клинические эффекты, показания к применению
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Анотація
Лекция посвящена одному из наиболее сложных вопросов современной кардиологии – применению антиаритмической терапии в клинической практике. В краткой форме рассмотрены основные механизмы аритмий, аспекты их возникновения, поддержания и прекращения. Обобщены современные данные об электрофизиологических механизмах сердечных аритмий, таких как циркуляция возбуждения (риэнтри) и аномалии генерации возбуждения (автоматии), а также эктопические возбуждения в форме триггерной активности. Приведены сведения о ремоделировании свойств ионных каналов. Рассмотрен Сицилианский гамбит, в котором механизмы аритмий сопоставлены с механизмами антиаритмического действия препаратов. Представлена классификация антиаритмических препаратов, описаны механизмы их действия, показания и противопоказания к применению, побочные эффекты, а также особенности взаимодействия.
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