急性心房动 (RAFF2) 的急诊室患者的电气与药物心脏转变:一个部分因子随机试验
Ian G Stiell1, Marco L A Sivilotti2, Monica Taljaard3
1Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Lancet (London, England)
|February 3, 2020
概括
药物心脏转换后的电心脏转换 (药物冲击) 和单独的电心脏转换 (仅冲击) 对急性心房非常有效. 这两种方法都能安全地恢复急诊室的鼻腔节律, 药物输注有助于大约一半的患者转化.
科学领域:
- 紧急医疗
- 心脏病学
- 临床试验
背景情况:
- 急性心房动是一种常见的急诊部表现.
- 有效和安全的治疗对于快速节律控制至关重要.
- 目前的策略包括药物和/或电动心脏转移.
研究的目的:
- 为了比较药物冲击与仅冲击的急性心房转换方案的有效性.
- 评估在电心转移过程中不同位的有效性.
主要方法:
- 在加拿大11个学术医院的急诊室进行了部分因数试验.
- 成年患有急性心房的患者被随机分为药物冲击或仅冲击的方案.
- 一个嵌套的随机比较评估了前后与前侧位的电动心脏转变.
主要成果:
- 药物冲击 (96%) 和仅冲击 (92%) 的策略都显示高转换率到鼻腔节奏.
- 大约52%的药物冲击组患者仅在药物输注后转化.
- 在前后和前侧位置之间没有显著的转换率差异 (94%对92%).
结论:
- 药物冲击和仅冲击的策略对于ED的急性心房是非常有效,快速和安全的.
- 在很大一部分患者中,药理性心脏转换可以避免手术镇静.
- 在这种情况下,位不会显著影响电心转变的成功.
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