Las arritmias en la amiloidosis cardiaca

Jorge Salinas-Arce; Raúl Alca-Clares; Ana Cecilia Gonzales-Luna; Mario Cabrera-Saldaña; Pablo Mendoza-Novoa; Paula Solórzano-Altamirano; Milton Guevara-Valdivia

doi:10.47487/apcyccv.v3i2.217

Autores/as

Jorge Salinas-Arce Unidad de Arritmias, Clínica Delgado. Lima, Perú. https://orcid.org/0000-0003-3045-3257
Raúl Alca-Clares Unidad de Arritmias, Clínica Delgado. Lima, Perú; Servicio de Cardiología, Hospital Cayetano Heredia. Lima, Perú. https://orcid.org/0000-0002-8446-7681
Ana Cecilia Gonzales-Luna Unidad de Arritmias, Clínica Delgado. Lima, Perú; Unidad de Arritmias, Hospital Edgardo Rebagliati. Lima, Perú. https://orcid.org/0000-0002-8575-1596
Mario Cabrera-Saldaña Unidad de Arritmias, Clínica Delgado. Lima, Perú; Unidad de Arritmias, Servicio de Cardiología Invasiva, Instituto Nacional Cardiovascular – INCOR EsSalud. Lima, Perú. https://orcid.org/0000-0001-9802-1376
Pablo Mendoza-Novoa Unidad de Arritmias, Clínica Delgado. Lima, Perú; Unidad de Arritmias, Hospital del Niño. Lima, Perú. https://orcid.org/0000-0002-2059-4403
Paula Solórzano-Altamirano Unidad de Docencia en Arritmias, APSA-QRS VITAL. Lima, Perú. https://orcid.org/0000-0002-2417-2531
Milton Guevara-Valdivia Departamento de Electrofisiología Cardiaca, Unidad Médica de Alta Especialidad del Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social. Ciudad de México, México. https://orcid.org/0000-0003-4663-5581

DOI:

https://doi.org/10.47487/apcyccv.v3i2.217

Palabras clave:

Amiloidosis, Arritmias Cardíacas, Electrofisiología

Resumen

La amiloidosis cardíaca (AC) es una forma de cardiomiopatía caracterizada por el depósito extracelular de fibrillas de proteínas en el miocardio, lo que produce insuficiencia cardíaca, arritmias y alteraciones en el sistema de conducción eléctrica. La mayoría de las cardiomiopatías tienen una estrecha relación con las alteraciones del ritmo cardiaco, en especial la AC que está asociada a diferentes formas de arritmias, incluso en fases previas al diagnóstico. Arritmias como la fibrilación auricular se observan hasta en el 70% de los pacientes con AC asociadas a un especial riesgo de complicaciones cardioembólicas independiente de la estratificación de riesgo. Las arritmias ventriculares son frecuentes; sin embargo, la colocación del cardiodesfibrilador implantable no ha demostrado mejorar la sobrevida. La enfermedad del sistema de conducción eléctrica también es común, y con frecuencia es necesario implantar un marcapaso definitivo, incluso en pacientes asintomáticos. En esta revisión delimitamos las recomendaciones de las guías más recientes, resumimos datos históricos y contemporáneos, y describimos estrategias basadas en evidencia para el manejo de arritmias y sus secuelas en la AC.

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