摘要
人的老化是有为健康条件和残疾的现在和将来的发生和流行的重要含意的一个全球问题。包括要求心律调整器放置的 atrial 纤维性颤动，突然的心脏的死亡，和 bradycardia，心脏的心律不齐都在 60 岁以后指数地增加。在心脏的 electrophysiology 和反常、病理学的改变上在老化的正常、生理的后果之间区分是重要的。年龄相关的心脏的变化包括室的肥大，老年的淀粉样变性病，心脏的瓣膜的退化变化和环形的石灰化，传导系统的含纤维的渗入，和自然心律调整器房间和这些变化的损失能在心律不齐的开发有深刻效果。年龄相关的心脏的 electrophysiological 变化包括特定的离子隧道表示和支持心脏的心律不齐的发展的细胞内部的 Ca2+ 超载的起来规定和下面规定。因为离子隧道是 antiarrhythmic 药的底层，因而，这些药的 pharmacokinetics 和药效学将也随着年龄变化。老化改变 antiarrhythmic 药的吸收，分发，新陈代谢，和消除因此肝和肾功能必须被监视避免潜在的不利的药效果，和 antiarrhythmic dosing 可以需要好久被调整。老病人也更产生许多 antiarrhythmics 的副作用，包括 bradycardia， orthostatic 低血压，尿保留，和下降。而且，在老病人的 antiarrhythmic 药的选择由 co 疾病的条件的存在并且由 polypharmacy，和精明的医生经常是复杂的必须对潜在的药药相互作用给予小心的注意。最后，记得在老病人的 antiarrhythmic 药的使用必须被有个性并且定制到每病人生理学，疾病过程，和药政体是重要的。
Human aging is a global issue with important implications for current and future incidence and prevalence of health conditions and disability. Cardiac arrhythmias, including atrial fibrillation, sudden cardiac death, and bradycardia requiring pacemaker placement, all increase exponentially after the age of 60. It is important to distinguish between the normal, physiological consequences of aging on cardiac electrophysiology and the abnormal, pathological alterations. The age-related cardiac changes include ventricular hypertrophy, senile amyloidosis, cardiac valvular degenerative changes and annular calcification, fibrous infiltration of the conduction system, and loss of natural pacemaker cells and these changes could have a profound effect on the development of arrhythmias. The age-related cardiac electrophysiological changes include up- and down-regulation of specific ion channel expression and intmcellular Ca2＋ overload which promote the development of cardiac arrhythmias. As ion channels are the substrates of antiarrhythmic drugs, it follows that the pharmacokinetics and pharmacodynamics of these drugs will also change with age. Aging alters the absorption, distribution, metabolism, and elimination of antiarrhythmic drugs, so liver and kidney function must be monitored to avoid potential adverse drug effects, and antiarrhythmic dosing may need to be adjusted for age. Elderly patients are also more susceptible to the side effects of many antiarrhytbanics, including bradycardia, orthostatic hypotension, urinary retention, and falls. Moreover, the choice of antiarrhythmic drugs in the elderly patient is frequently complicated by the presence of co-morbid conditions and by polypharmacy, and the astute physician must pay careful attention to potential drug-drug interactions. Finally, it is important to remember that the use of antiarrhythmic drugs in elderly patients must be individualized and tailored to each patient＇s physiology, disease processes, and medication regimen.
