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Fibrillación auricular asintomática o "silenciosa": frecuencia en pacientes no tratados y en pacientes que reciben
Richard L Page1, Thomas W Tilsch, Stuart J Connolly
1Cardiovascular Division, Clinical Cardiac Electrophysiology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, USA. rpage@u.washington.edu
Circulation
|March 5, 2003
Resumen
La fibrilación auricular asintomática es común en pacientes con fibrilación auricular sintomática. La azimilida puede reducir la aparición de esta arritmia silenciosa, lo que sugiere un beneficio potencial del tratamiento.
Área de la Ciencia:
- Cardiología Cardiología.
- Electrofisiología y electrofisiología.
- Farmacología Farmacología.
Sus antecedentes:
- La fibrilación auricular asintomática (silenciosa) plantea un riesgo de accidente cerebrovascular.
- No se comprende bien la prevalencia de la fibrilación auricular asintomática en pacientes con fibrilación auricular sintomática.
- El impacto de los medicamentos antiarrítmicos en la fibrilación auricular asintomática requiere más investigación.
Objetivo del estudio:
- Para determinar la frecuencia de la fibrilación auricular asintomática en pacientes con antecedentes de fibrilación auricular sintomática.
- Para evaluar el efecto de la azimilida, un medicamento antiarrítmico, en la fibrilación auricular asintomática.
Principales métodos:
- Cuatro ensayos doble ciego en los que participaron 1380 pacientes con antecedentes de fibrilación auricular sintomática o aleteo.
- Los pacientes recibieron placebo o azimilida (35-125 mg) todos los días durante 6-9 meses.
- Se realizaron electrocardiogramas transtelefónicos de rutina cada dos semanas para detectar arritmias supraventriculares asintomáticas.
Principales resultados:
- La fibrilación auricular asintomática se detectó en el 17% de los pacientes con placebo dentro de los 6 meses.
- En ensayos de dosis terapéutica, la fibrilación auricular asintomática se produjo en el 13% de los receptores de azimilida frente al 18% de los receptores de placebo.
- Se observó una reducción estadísticamente significativa del 40% en la fibrilación auricular asintomática con azimilida en comparación con el placebo (P = 0,03).
Conclusiones:
- La fibrilación auricular asintomática es prevalente en pacientes con fibrilación auricular sintomática.
- La azimilida demostró un potencial para disminuir la incidencia de la fibrilación auricular asintomática.
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