在导管切除后预防心房的复发:一个随机的,安慰剂控制的试验
Alexander P Benz1,2, Guy Amit3, Stuart J Connolly1
1Population Health Research Institute (A.P.B., S.J.C., J.S., D.C., W.F.M., J.D.R., J.A.W., R.Z., J.S.H.), Hamilton, ON, Canada.
Circulation. Arrhythmia and electrophysiology
|December 21, 2023
概括
在心房动 (AF) 移除后,短期使用素治疗并没有减少心律失常的复发. 然而,它确实降低了切除后的胸痛,但在接受AF切除的患者中增加了腹的发生率.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症是心房动 (AF) 复发的潜在驱动因素.导管切除后的复发.
- 调查抗炎药物,如胆固醇,可能提供一个策略,以改善废除结果.
研究的目的:
- 评估短期素治疗方案在AF导管切除后预防心房律乱复发的疗效.
- 评价术前菌素对剥离后并发症和临床结果的影响.
主要方法:
- 一个随机的,安慰剂对照试验,涉及199名接受AF切除的患者.
- 参与者接受了胆固醇 (0.6毫克每天两次,持续10天) 或安慰剂,第一个剂量是在剥离前给予的.
- 在2周和3个月后通过Holter监测心房律乱的复发.
主要成果:
- 胆固醇并没有显著减少2周 (31%对32%) 或3个月 (14%对15%) 的心房律乱复发.
- 科尔奇辛组 (4%对15%) 观察到,切除后胸痛显著减少,暗示心周炎.
- 胆固醇组的腹发病率较高 (26%对比7%).
结论:
- 在AF废除后,给药10天的胆固醇并没有减少心房律乱的复发或与AF相关的临床事件.
- 科尔奇辛有效地减少了切除后的胸痛,但与腹风险增加有关.
- 在这个队列中,素的抗炎作用并没有转化为改善无心律失常的存活率.
相关概念视频
Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
1.0K
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
1.0K
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.4K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.4K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
747
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
747
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
840
Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
840
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
19
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
19
Antianginal Drugs: Calcium Channel Blockers and Ranolazine
519
Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
519


