对于心房的患者,医生对穿皮左心房尾封闭的看法
Devika Kir1, Holly K Van Houten2, Kelli N Walvatne2
1Department of Cardiovascular Diseases, Mayo Clinic, Rochester MN.
American heart journal
|August 11, 2023
概括
医生对跨导管左心房尾阻塞 (LAAO) 的看法对于减轻心房中风的看法有很大的不同. 影响LAAO决策的关键因素包括出血史和感知风险,没有基于患者种族或性别的偏见.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 预防中风 预防中风
背景情况:
- 过导管左心房尾阻塞 (LAAO) 越来越多地用于减轻心房 (AF) 中的中风.
- 了解医生的看法对于优化LAAO采用和实践模式至关重要.
研究的目的:
- 调查一个多元化的医生样本对LAAO的看法和方法.
- 确定影响决定推或拒绝LAAO用于AF中风预防的因素.
主要方法:
- 在2000名医生 (一般心脏病学家,干预心脏病学家,电生理学家,血管神经学家) 进行了一项全国性调查.
- 医生通过邮件收到调查,多达三次后续检查.
- 根据种族和性别而异的患者简历被用来评估决策偏见.
主要成果:
- 考虑LAAO的主要原因包括先前的内出血 (94.3%),主要的外出血 (91.8%),以及胃肠道病变 (59.0%).
- 拒绝使用LAAO的原因包括需要口服抗凝药 (87.7%),低出血风险 (77.0%) 和低中风风险 (65.6%).
- 程序风险 (59.8%) 和有限的比较疗效/安全数据 (42.6%/32.8%) 是LAAO建议的关键限制. 没有观察到基于患者的种族或性别的偏见.
结论:
- 医生对LAAO用于AF中风预防的看法非常多样化.
- 鉴定到的证据缺口凸显了未来研究的需要,以建立一致的,基于证据的最佳实践.
- 结果将为不同的医生群体提供量身定制的教育计划.
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