在患有肥胖症的患者中,心房的双重与单一心脏转变:一项随机临床试验
Joshua D Aymond1, Alexandra M Sanchez1, Michael R Castine2,3
1Division of Cardiac Electrophysiology, Ochsner Medical Center, New Orleans, Louisiana.
JAMA cardiology
|May 22, 2024
概括
双直流心脏转换 (DCCV) 在患有心房动的肥胖患者中显著提高恢复正常心律的成功率. 这种方法是安全有效的,为单心脏转换提供了更好的替代方案.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 肥胖医学 肥胖医学
背景情况:
- 心房动和肥胖是普遍存在的,并且越来越多的疾病.
- 肥胖与心房的标准心脏转变成功率降低有关.
研究的目的:
- 为了比较双直流心脏转换 (DCCV) 与单个DCCV在患有心房的肥胖患者中的疗效和安全性.
- 评估与不同心脏转变配置相关的成功率和不良事件.
主要方法:
- 一项前性随机临床试验,涉及200名肥胖患者 (BMI ≥35) 与心房动.
- 患者被随机分配,接受双双DCCV (2组,每组200J) 或单个DCCV (1组,每组200J).
- 结果包括恢复鼻节律,不良心血管事件和胸部不适.
主要成果:
- 与单个DCCV (86%) 相比,双DCCV的成功率 (98%) 显著更高 (P=.002).
- 双DCCV是心脏转变成功的重要预测因素 (OR,6.7).
- 两组之间没有观察到术后胸部不适或心血管并发症的显著差异.
结论:
- 双DCCV在肥胖和心房的患者中实现心脏转变方面比单个DCCV更有效.
- 这种方法可以提高成功率,而不会增加不良事件或患者的不适.
- 双DCCV代表了管理肥胖人口中心房动的一个有价值的进步.
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