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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Diagnostic evaluation and arrhythmia mechanisms in survivors of unexplained cardiac arrest
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Diagnostic evaluation and arrhythmia mechanisms in survivors of unexplained cardiac arrest

机译：未解释的心脏骤停幸存者诊断评价和心律失常机制

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Abstract Identifying the cause of unexplained cardiac arrest is critical for appropriate management of both survivors and their family members. Aborted cardiac arrests whose cause remains unknown following investigation with a surface ECG, echocardiogram, and coronary angiogram are deemed unexplained. Many of these unexplained arrests are felt to be secondary to concealed forms of cardiac channelopathies and latent or subtle cardiomyopathies. This recognition has led to evaluating a diagnostic role for a series of additional investigations, including advanced imaging, genetic testing, and provocative forms of testing, including sodium channel blockade and treadmill testing. Despite evidence of an improved diagnostic yield through their systematic usage, clinical guidelines have yet to endorse a formal algorithm delineating investigations that must be performed before assigning a label of idiopathic ventricular fibrillation, which has resulted in markedly variables thresholds for concluding this diagnosis. Debate remains regarding the need for an invasive electrophysiology study among these patients, though identification of arrhythmic culprits requiring intracardiac electrograms for diagnostic confirmation have suggested a potential role when an initial comprehensive evaluation is unrevealing. Although progress is being made, the sizeable portion of arrests that remain unexplained despite completion of a comprehensive evaluation highlights an ongoing need for further research and additional tools to help unravel the ongoing mysteries of these near fatal events.
机译：摘要识别不明原因的心脏骤停的原因对于适当管理幸存者及其家庭成员来说至关重要。在用表面心电图中调查后，其原因仍然未知的心脏骤停，超声心动图和冠状动脉血管造影被认为是未解释的。许多这些无法解释的逮捕都被审查是隐藏形式的心脏通道和潜在的或微妙的心肌病。此识别导致评估一系列额外调查的诊断作用，包括先进的成像，遗传检测和挑衅性的测试形式，包括钠通道封锁和跑步机测试。尽管证据证明通过其系统使用情况改善了诊断产量，但临床指南尚未认可在分配特发正室颤动的标签之前必须进行的正式算法划定研究，这导致了明显的变量阈值来结束这种诊断。辩论仍然有需要在这些患者中进行侵入性电生理学研究，尽管鉴定需要心律失常的诊断证实诊断确认的诊断表现出潜在的作用，但在初步综合评估越来越缺乏时。虽然正在取得进展，但尽管完成综合评估尽管完成了综合评估，但仍然无法解释的逮捕部分突出了进一步的研究和额外工具，以帮助解开这些附近致命事件的持续奥秘。

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