第五章:指导方针建议:哪个AAD和为谁?
Thomas F Deering1, James A Reiffel2, Allen J Solomon3
1Piedmont Healthcare, Atlanta, GA, USA.
The American journal of cardiology
|September 30, 2023
概括
管理心房动 (AF) 的指导方针侧重于抗心律失常药物 (AAD) 选择. 在最近的一项调查中,不适当的药物选择和患者选择是常见的,这表明AF治疗的指导方针导向护理存在差距.
科学领域:
- 心脏病学 心脏病学
- 临床指南 临床指南
- 药理学 药理学是指药理学的学科.
背景情况:
- 来自AHA/ACC/HRS和ESC的心房动 (AF) 管理指南为抗不律性药物 (AAD) 选择提供了框架.
- AAD选择受到患者因素的影响,例如结构性心脏病 (SHD),冠状动脉疾病和心力衰竭 (HF) 类型.
研究的目的:
- 讨论AF管理的当前指南,重点关注适当的AAD选择.
- 确定适合AAD治疗的患者群体,并评估对指导方针导向护理的遵守.
主要方法:
- 对AF管理的AHA/ACC/HRS和ESC指南的审查.
- 来自AIM-AF调查的数据分析,这是对心脏病学家和电生理学家之间的AF管理实践的跨国研究.
主要成果:
- 针对AAD选择的指导方针建议是基于安全性,考虑SHD,CAD和HF.
- 该AIM-AF调查揭示了指导方针导向护理的不一致应用,在各种药物类别和患者群体中观察到不适当的AAD选择和患者向.
- 值得注意的发现包括在没有SHD的患者中过度使用amiodarone,以及在HFrEF患者中不适当使用sotalol.
结论:
- 关于AF选择,AF管理的既定指南与实际的临床实践之间存在很大的差距.
- 改善对指导方针指导护理的坚持是必要的,以优化对心房的抗心律失常药物治疗的安全性和有效性.
- 需要进一步的教育和实施战略,以确保在AF管理中进行适当的患者选择和药物选择.
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