Banu YILDIZ ŞAHİN, Mustafa YILDIZ, Mustafa Ozan GÜRSOY

High altitude and ıntracardiac devices (pacemaker and ıntracardiac defibrillator and cardiac resynchronisation therapy)

Kardiyovasküler sistem yüksek irtifa maruziyetine kısa sürede cevap verir. Hipoksi kalp hızını, miyokard kasılmasını ve kardiyak debiyi artırır. Bu özellikle kalp yetersizliği, ritm bozukluğu ve koroner arter hastalığı gibi altta yatan kalp hastalığı olduğu durumlarda klinik önem arz edebilir. Geçmişte yapılmış çalışmalarda yüksek irtifaya bağlı ritm bozuklukları bazı hastalarda gözlenmiştir. Fakat kalıcı pil, intrakardiyak defibrilatör (IKD) ve kardiyak resenkronizasyon terapisi (KRT) gibi kalp cihazlarıyla ilgili çelişkili sonuçlar mevcuttur. Kısıtlı sayıda yapılan çalışmalarda yüksek irtifaya maruz kalmış kalp pili olan hastalarda yüksekliğin ventriküler stimulasyon eşiği üzerinde etkisinin olmadığı ve bu durumun güvenilir olduğu gösterilmiştir; fakat günümüzde yüksek irtifanın IKD ve KRT cihazları üzerindeki etkisi halen net olarak bilinmemektedir ve daha fazla çalışmaya ihtiyaç vardır.

Yüksek irtifa ve intrakardiyak cihazlar (pacemaker ve intrakardiyak defibrilatör ve kardiyak resenkronizasyon tedavisi)

Cardiovascular system responds to high altitude short after exposure. Hypoxia induces increase in heart rate, myocardial contractility, and cardiac output. This may have clinical implications in patients with underlying heart disease such as coronary artery disease, heart failure and rhythm disorders. Past studies have showed that patients may experience altitude-induced arrhythmias. However, there are conflicting data for patients with cardiac devices such as permanent pacemaker, intracardiac defibrillators (ICDs) and cardiac resynchronisation therapies (CRTs). Limited studies demonstrate that patients with pacemakers can be safely exposed to high altitudes with no impact on ventricular stimulation thresholds, however effects of altitude on ICDs or CRTs are still unknown at the present time requiring further research.

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