使用症状诱导的重复剂量治疗心室节依赖性心室高心率 (RAPID) 的自我注射内乙:多中心随机试验
Bruce S Stambler1, A John Camm2, Marco Alings3
1Cardiac Arrhythmia Research and Education, Piedmont Heart Institute, Atlanta, GA, USA.
Lancet (London, England)
|June 18, 2023
概括
在30分钟内,埃特利帕米尔鼻喷剂有效地和安全地将心肺上心率转换为鼻腔节律. 这种快速起作用的疗法使患者能够在医疗机构以外的医疗机构进行按需治疗.
科学领域:
- 心脏病学
- 药理学
背景情况:
- 埃特里帕米尔是一种用于治疗心肺上高心率 (PSVT) 的鼻内道阻塞剂.
- 目前的PSVT治疗通常需要医疗机构.
研究的目的:
- 评估70mg鼻喷剂在急性转化PSVT到鼻腔节律中的疗效和安全性.
- 评估在医疗机构以外的症状引起的重复剂量治疗方案.
主要方法:
- 一个多中心,随机,安慰剂对照试验 (RAPID) 涉及已记录PSVT的患者.
- 患者在症状出现时自行服用乙胺或安慰剂,可选择重复服用.
- 主要终点:通过心电图确认30分钟内转换为鼻腔节律的时间.
主要成果:
- 与安慰剂 (31%) 相比,埃特里帕米尔在30分钟内表现出显著更高的转化率 (64%) (HR2. 62, p< 0. 0001).
- 与安慰剂 (53. 5分钟) 相比,乙胺的转化时间中位数显著缩短.
- 大多数治疗出现的不良反应是轻度/ 中度的鼻部反应,过渡性,并且没有干预就消失了.
结论:
- 随着症状的出现,自行注射鼻乙是有效的,安全的,并且在快速PSVT转化方面优于安慰剂.
- 这种方法有助于增强患者权力,减少急性护理干预的需要.
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