Электрическая нестабильность миокарда у детей разного возраста: диагностика, прогностическая значимость и принципы коррекции (обзор литературы)

Электрическая нестабильность миокарда (ЭНМ) представляет собой изменение электрофизиологических свойств миокарда, сопряженное с различной степенью риска реализации жизнеугрожающих состояний. На сегодняшний день особенно остро стоит проблема диагностики и клинической интерпретации ЭНМ у новорожденных детей ввиду анатомо-физиологических особенностей и коморбидных состояний, а также у детей и подростков с органическими болезнями сердца. Изучение гетерогенности электрокардиографической (ЭКГ) морфологии кардиоциклов может иметь прогностическую ценность для предотвращения аритмических событий. В статье представлен обзор современных научных данных о признаках ЭНМ у детей, в том числе периода новорожденности, сформированных в две большие группы: нарушения деполяризации и реполяризации. Обсуждаются ЭКГ-критерии ЭНМ у детей разного возраста с врожденными (первичными) электрическими заболеваниями и приобретенными состояниями, в том числе с COVID-19. Освещены методы медикаментозной коррекции ЭНМ у новорожденных и детей в последующие возрастные периоды. Совокупность представленных данных диктует необходимость дальнейшего изучения прогностической значимости ЭМН и методов ее коррекции.

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