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在膜封闭后预防心房失律的flekainide:AFLOAT研究,一项随机临床试验
Marie Hauguel-Moreau1, Paul Guedeney2, Claire Dauphin3
1ACTION Study Group, CESP, INSERM U1018, Department of Cardiology, Ambroise Paré Hospital (AP-HP), Université de Versailles-Saint Quentin, Boulogne, France (M.H.-M.).
Circulation
|September 2, 2024
概括
在最近的一项试验中,Flecainide在孔封闭后没有预防心房失律 (AA). 在手术后6个月内,主要是在第一个月内,有28. 5%的患者出现心房失常.
科学领域:
- 心脏病学
- 干预心脏病学
- 电生理学
背景情况:
- 在膜封闭后心房律乱 (AA) 的发生率尚未确立.
- 需要进一步调查PFO关闭后的预防策略.
研究的目的:
- 在PFO关闭后的前三个月内评估flekainide在预防AA方面的有效性.
- 为了比较3个月的治疗和6个月的治疗对于PFO关闭后的AA预防的有效性.
主要方法:
- 一个前性的,多中心的,随机的,开放的优越性试验 (AFLOAT) 与盲目的终点评估.
- 186名患者被随机分为接受3个月的飞胺,6个月的飞胺或PFO关闭后的标准护理.
- 主要终点是可插入心脏监测器在3个月内检测到的AA患者的百分比 (≥30秒).
主要成果:
- 在PFO关闭后6个月内,有28. 5%的患者出现心房失常 (≥30秒),其中86. 8%发生在第一个月.
- 与标准治疗相比,弗莱卡尼德治疗 (3 个月或 6 个月) 并没有显著降低 AA 的发生率.
- 在3个月和6个月的弗莱卡尼德治疗时间之间没有明显的差异.
结论:
- 前庭心律失常是PFO关闭后的常见并发症,主要发生在第一个月内.
- 在测试剂量和持续时间下,Flecainide在PFO关闭后无法有效预防心房律乱.
- 需要进一步研究以确定PFO关闭后AA的有效预防策略.
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