在患有心房和心力衰竭的患者中早期节律控制治疗
Andreas Rillig1,2, Christina Magnussen1,2, Ann-Kathrin Ozga3
1Department of Cardiology, University Heart and Vascular Center (A.R., C.M., P.K.), University Medical Center Hamburg-Eppendorf, Germany.
Circulation
|July 30, 2021
概括
早期节律控制疗法可显著减少心力衰竭和心房动患者的心血管并发症. 这种方法在诊断后的一年内开始时是有益的.
科学领域:
- 心脏病学
- 电生理学
- 心脏衰竭的治疗方法
背景情况:
- 许多心力衰竭和心房的患者面临心血管并发症尽管最佳治疗.
- 需要进行额外的治疗,特别是在心力衰竭和左心室喷射分数保留的情况下.
研究的目的:
- 评估系统的,早期节律控制治疗 (ERC) 与常规护理对心力衰竭和心房动患者的心血管结果的影响.
- 评估ERC对不同程度的左心室喷射分数 (LVEF) 患者的初级和二级结局的影响.
主要方法:
- 一项随机EAST- AFNET4试验的亚分析,涉及798名心力衰竭患者 (NYHA II- III或LVEF<50%).
- 患者被分配到早期节律控制治疗 (抗节律药物或导管切除) 或通常的护理.
- 随访时间平均为5. 1年.
主要成果:
- 综合初级结局 (心血管死亡,中风或心力衰竭/ 急性冠状动脉综合征住院) 与常规治疗相比发生较少 (5. 7 事件/100 患者年; HR,0. 74; P=0. 03).
- 主要安全结果显示ERC与常规护理之间没有显著差异 (HR,0. 85;P=0. 33).
- 在这两组中,左心室喷射分数有所改善,ERC也改善了死亡或心力衰竭住院的综合结果.
结论:
- 对心力衰竭和心房动患者来说,系统的早期节律控制疗法具有临床益处.
- 对于出现心力衰竭症状的患者,建议在诊断心房后的一年内开始节律控制治疗.
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