专家共识关于全面的早期节律控制,除了基于指导方针的治疗心房动:修改后的德尔菲调查
Thomas F Deering1, Jonathan P Piccini2, Marlon Graf3
1Piedmont Heart Institute, Atlanta, Georgia.
The American journal of cardiology
|September 29, 2023
概括
电生理学家倾向于对心房 (AF) 进行早期节律控制,以改善结果和症状. 专家的共识支持迅速干预,在AF管理中优先考虑缓解症状和治疗安全性.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学指导方针 医学指导方针
背景情况:
- 当前心房的指导方针建议节律控制以提高生活质量.
- 抗节律药物和导管切除有已知的副作用.
- 新兴研究表明,早期节律控制可能会减少不良心血管结果.
研究的目的:
- 检查电生理学家关于AF早期节律控制策略的观点.
- 为了在AF患者的治疗决策方面达成专家共识.
- 确定影响早期节律控制和常规护理之间的选择的关键因素.
主要方法:
- 使用了在线修改的Delphi调查.
- 17名电生理学家参与了排名和概率问题.
- 该调查重点关注早期节律控制和治疗选择因素的使用.
主要成果:
- 达成共识,支持早期节律控制 (中位数为90).
- 专家认为,早期干预可以改善心血管结果和症状.
- 与AF相关的症状 (1.1/7) 和AF类型 (2.5/7) 是关键的决定因素,在症状出现时开始治疗 (中位数为80).
- 安全性 (1.9/7) 和有效性 (1.8/7) 在治疗选择中至关重要.
结论:
- 专家支持对心房动进行早期节律控制.
- 需要进一步的研究,以将早期节律控制策略整合到AF治疗算法中.
- 该研究强调了症状负担和安全在AF临床决策中的重要性.
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