在心力衰竭和心房的患者中随机抽取的节律控制与节律控制试验:RAFT-AF试验的结果
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Updated: Sep 29, 2025

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Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
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Ratika Parkash1, George A Wells2, Jean Rouleau3
1Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada (R.P., J.L.S.).
Circulation
|March 22, 2022
概括
与控制率相比,心力衰竭 (HF) 患者的心脏动 (AF) 基调节律控制没有显著的死亡率或HF事件差异. 然而,消化趋向于更好的结果和更好的生活质量.
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:
- 心房动 (AF) 和心力衰竭 (HF) 经常同时存在,这给治疗带来了复杂的挑战.
- 药理学节律控制对AF没有证明优于速率控制.
- 这项研究调查了基于除的节律控制是否改善了AF的HF患者的结果.
研究的目的:
- 在患有同时存在的AF和HF的患者中,比较基于除的节律控制与节律控制的疗效.
- 评估对临床结果的影响,包括死亡率和HF事件.
- 评估心脏功能和生活质量等次要结果.
主要方法:
- 这是一项多中心的开放试验,对结果进行了盲目评估.
- 有411名患有高负担的AF,NYHAII- III级HF和高NT- proBNP的患者被随机分组.
- 主要结果:综合所有原因死亡率和HF事件. 至少2年的随访时间.
主要成果:
- 在消化 (23. 4%) 和控制率 (32. 5%) 组之间,主要结果没有统计学意义上的差异 (HR 0. 71; P=0. 066).
- 切除组显示LVEF,6分钟步行距离和NT-proBNP水平显著改善.
- 在废除组 (MLWHFQ,AFEQLI分数) 观察到生活质量的更大改善.
结论:
- 与控制率相比,在该患者群体中,以消化为基础的节律控制没有显著降低死亡率或HF事件.
- 一个无意义的趋势有利于改善结果的消去.
- 尽管在主要终点上缺乏统计意义,但心脏功能和生活质量的显著改善表明了切除的潜在益处.
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