节律与节律控制治疗以及随后的中风或过渡性缺血性发作在心房的患者中
Meytal Avgil Tsadok1, Cynthia A Jackevicius, Vidal Essebag
1MPH, McGill University Health Centre, 687 Pine Ave West, V Building, Montreal, Quebec, H3A 1A1 Canada.
Circulation
|November 6, 2012
概括
与节律控制治疗相比,心房动患者的中风和暂时性缺血性发作 (TIA) 风险显著降低. 这种益处在高危人群中最为明显.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 药理学 药理学 是一个学科.
背景情况:
- 心房动增加了中风的风险.
- 对于死亡率来说,速度和节律控制是可以接受的,但中风率差异不清楚.
研究的目的:
- 为了在心房动患者中比较节律和节律控制疗法之间的中风/TIA率.
主要方法:
- 基于人口的观察性研究 (北克省,1999-2007年) 使用链接的行政数据.
- 在节律控制 (Ia,Ic,III类) 与节律控制 (β阻塞剂,CCBs,狄戈辛) 的患者中,比较中风/TIA的发生率.
- 使用多变量考克斯回归和倾向得分匹配.
主要成果:
- 16,325名患者接受节律控制,41,193名患者接受节律控制;平均随访时间为2.8年.
- 原始中风/TIA率:1.74/100人/年 (节律) 与2.49/100人/年 (率),P<0.001.
- 节律控制与较低的中风/TIA风险相关 (aHR 0.80,95% CI 0.74-0.87),特别是在中度/高 CHADS (2) 风险组.
结论:
- 在心房动患者中,节律控制疗法与较低的中风/TIA比率控制相关.
- 这种益处对中风风险中等至高的患者尤为重要.
相关概念视频
Pulse rhythm
1.7K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.7K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
2.3K
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
2.3K
Disturbances in Heart Rhythm
5.5K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
5.5K
Dysrhythmias VI: Management of Dysrhythmias
598
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
598
Dysrhythmias VII: Nursing Management of Dysrhythmias
510
Nursing management of dysrhythmias involves the following:AssessmentSubjective Assessment:The initial step involves gathering patient-reported symptoms such as dizziness, palpitations, and chest discomfort. It is crucial to collect a detailed history, including previous heart conditions, current medication use, and lifestyle factors like caffeine and alcohol consumption.Objective Assessment:This involves observing clinical signs such as jugular venous distention, cool and pale skin, and...
510
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
1.2K
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
1.2K


