在持续性心房的患者中,在未成功的电动心脏转移后进行废除疗法
Hyo Jin Lee1, Su Hyun Lee1, Juwon Kim1
1Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Scientific reports
|October 7, 2024
概括
对于持久性心房 (AF) 患者,没有成功的电心转移 (ECV),除疗法显著改善了与医疗管理相比的无AF生存率. 这一发现不论采用了哪种废弃方法,都适用.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗干预 医疗干预
背景情况:
- 电动心脏转变 (ECV) 是一种常见的治疗持续性心房动 (AF),旨在恢复正常的心律.
- 电心并非总是有效的,需要评估长期节律控制的替代策略.
- 在ECV失败后确定最佳疗法对于管理持续性AF至关重要.
研究的目的:
- 为了比较非废除疗法与废除疗法的有效性,在不成功的ECV后患有持续AF的患者中进行废除疗法.
- 评估在不成功的ECV和随后的治疗后影响AF复发的因素.
主要方法:
- 对125名连续患有持续性AF的患者进行了回顾性分析,这些患者接受了不成功的ECV.
- 患者被分为两组:非废除疗法 (医疗管理) 和废除疗法 (导管或胸腔镜废除).
- 结果,主要是AF无存活率,在两组之间进行了比较,并分析了AF复发的预测因素.
主要成果:
- 与非废除疗法相比,废除疗法显示出明显更好的无AF生存率 (HR 0.37,p < 0.01).
- 在导管切除和胸腔镜切除之间没有观察到无关节炎生存时间的显著差异.
- AF复发的预测因素包括较长的AF持续时间,较低的BMI (≤25 kg/m2) 和糖尿病.
结论:
- 废除疗法是一种优于非废除疗法的策略,用于在不成功的ECV后维持持续性AF患者的鼻节律.
- 导管和胸腔镜切除之间的选择似乎不会影响无关节炎生存率.
- 在管理持续性AF后ECV失败时,应考虑AF持续时间,BMI和糖尿病状况等患者因素.
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