medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-420medsovet-8613Research ArticleАРИТМИИARRHUTHMIASСиндром приобретенного удлиненного интервала QT как предиктор внезапной сердечной смерти: причины, критерии диагностики, стратегия леченияAcquired long QT interval syndrome as a predictor of sudden cardiac death: Causes, diagnostic criteria, and management strategyhttps://orcid.org/0000-0002-2164-3537СкворцовВ. В.SkvortsovV. V.

Скворцов Всеволод Владимирович, д.м.н., профессор кафедры внутренних болезней

400131, Волгоград, площадь Павших Борцов, д. 1

Vsevolod V. Skvortsov, Dr. Sci. (Med.), Professor of the Department of Internal Diseases

1, Pavshikh Bortsov Square, Volgograd, 400131

vskvortsov1@ya.ruhttps://orcid.org/0000-0002-3595-2023КоломыцевВ. В.KolomytsevV. V.

Коломыцев Виктор Викторович, студент

400131, Волгоград, площадь Павших Борцов, д. 1

Victor V. Kolomytsev, Student

1, Pavshikh Bortsov Square, Volgograd, 400131

eRST142@yandex.ruhttps://orcid.org/0009-0006-8772-9823ГорюноваЛ. В.GoryunovaL. V.

Горюнова Лидия Владимировна, студент

400131, Волгоград, площадь Павших Борцов, д. 1

Lidia V. Goryunova, Student

1, Pavshikh Bortsov Square, Volgograd, 400131

Lidiagor200@mail.ruВолгоградский государственный медицинский университетРоссияVolgograd State Medical UniversityRussian Federation2024301020240166369Copyright © Скворцов В.В., Коломыцев В.В., Горюнова Л.В., 20242024Скворцов В.В., Коломыцев В.В., Горюнова Л.В.Skvortsov V.V., Kolomytsev V.V., Goryunova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8613

Несмотря на достижения медицины в диагностике и лечении, сердечно-сосудистые заболевания продолжают занимать лидирующие позиции в глобальной статистике смертности. Внезапная сердечная смерть, являясь крайним и необратимым исходом остановки сердца, наблюдается в 50% случаев, что нередко становится первой внезапно выявленной патологией. Синдром удлиненного интервала QT – вариант электрической болезни сердца, которая является следствием как врожденного, так и приобретенного нарушения функции и/или регуляции ионных каналов кардиомиоцитов, что сопровождается нарушением процессов деполяризации и реполяризации миокарда желудочков и характеризуется удлинением QT и аномалиями Т на электрокардиограмме, клинически сопровождается синкопальным состоянием, двунаправленной веретенообразной желудочковой тахикардией по типу «пируэт» (torsade de pointes), ассоциируется с высоким риском внезапной сердечной смерти или синдромом внезапной аритмической смерти. Эффективное ведение таких пациентов требует индивидуального подхода: тщательное обследование, расчет скорректированного QT, определение типологии (наследственный или приобретенный синдром), оценка рисков по шкале Тисдейла и подбор оптимальной терапии. Лечение должно быть комплексным и включать медикаментозные (β-адреноблокаторы, коррекция электролитного баланса) и хирургические методы (установка имплантируемого кардиовертер-дефибриллятора и грудная левосторонняя симпатическая денервация сердца), а также коррекцию образа жизни (исключить прием медикаментов, способствующих удлинению интервала QT; избегать специфических триггеров аритмии – активное плавание, воздействие громких звуков) и регулярные консультации у кардиолога. Своевременная диагностика и комплексный подход – залог успешной профилактики внезапной сердечной смерти у пациентов с синдромом удлиненного интервала QT.

Despite medical advances in diagnosis and treatment, cardiovascular disease remains the leading cause of death worldwide. Sudden cardiac death, an extreme and irreversible outcome of cardiac arrest, is observed in 50% of cases and is often the first suddenly detected pathology. Long QT syndrome is a variant of electrical heart disease resulting from both congenital and acquired dysfunction and/or regulation of cardiomyocyte ion channels, accompanied by impaired depolarization and repolarization of the ventricular myocardium and characterized by QT prolongation and T abnormalities on the electrocardiogram, clinically accompanied by syncope, bidirectional spindle ventricular tachycardia of the “pirouette” type (torsade de pointes), associated with a high risk of sudden cardiac death or sudden arrhythmic death syndrome. Effective management of these patients requires an individualized approach: careful examination, calculation of corrected QT, determination of typology (hereditary or acquired syndrome), risk assessment using the Tisdale scale, and selection of optimal therapy. Treatment should be comprehensive and include pharmacological (beta-adrenergic blockers, correction of electrolyte balance) and surgical (implantable cardioverter-defibrillator and left-sided thoracic sympathetic denervation of the heart), lifestyle (avoidance of drugs that contribute to prolongation of the QT interval, avoidance of specific arrhythmia triggers (active swimming, exposure to loud noises)) and regular consultation with a cardiologist. Early diagnosis and a comprehensive approach are key to successful prevention of sudden cardiac death in patients with Long QT syndrome.

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