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

Authors

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

Keywords:

Amyloidosis, Arrythmias, Cardiac, Electrophysiology

Abstract

Cardiac amyloidosis (CA) is a form of cardiomyopathy characterized by the extracellular deposit of protein fibers in the myocardium, leading to the development of heart failure, arrhythmias, and electrical conduction system alterations. It is known that most cardiomyopathies have a close relationship with heart rhythm abnormalities, however, CA is specially related to different kinds of arrhythmias even in pre-diagnosis stages. Arrhythmias like atrial fibrillation are present in up to 70% of patients with CA associated with a high risk of cardioembolic complications independent of the risk stratification. Ventricular arrhythmias are frequent, but the use of implantable cardioverter defibrillator has not been demonstrated to improve survival. The Atrial-Ventricular node disease is also common, and is frequently associated with the implantation of a pacemaker, even in asymptomatic patients. In this review, we clarify the recommendations of the most current guidelines, summarize historical and contemporaneous data and describe evidence-based strategies for the management of arrhythmias and their complications in CA.

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