在复发性心房动中长期坚持使用 flecainide 作为节律控制疗法 - - 一项回顾性队列研究
Alexander Siotis1,2, Samuel Johansson3, Claus Graff4
1Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Lund University, Helsingborg, Sweden.
Scandinavian cardiovascular journal : SCJ
|June 24, 2025
概括
对心房 (AF) 停药的长期弗莱卡尼德治疗与特定的心电图 (ECG) 和心声回声指数有关. 这些包括P波持续时间,左心房体积指数和右心室功能,影响治疗的安全性和有效性.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏成像 - - 心脏成像
背景情况:
- 弗莱卡尼德是心房动 (AF) 节律控制的主要治疗方法.
- 弗莱卡尼德治疗成功的长期结果和预测因素尚未得到充分证实.
- 了解影响弗莱卡尼德有效性和安全性的因素对于患者管理至关重要.
研究的目的:
- 在AF患者中识别与长期弗莱卡尼尼德治疗结果相关的心电图 (ECG) 和心声标志物.
- 调查弗莱卡尼德停用,节律控制失效和不良事件的预测因素.
- 为了增强个性化治疗策略的AF管理与flecainide.
主要方法:
- 对130名AF患者进行了回顾性研究,该研究始于使用flekainide.
- 评估基线心电图参数 (P波持续时间,DTNP-V1) 和心声回声指数 (LAVI,功能障碍,RV-FAC).
- 随访时间中位数为1.5年,记录停药,节律控制失效和不良事件.
主要成果:
- 31%的患者停止了弗莱卡尼德;14%是由于节律控制失败,10%是由于不良事件.
- 弗莱凯尼德的停用与延长的P波持续时间 (PWD ≥130ms),阳性DTNP-V1 (>0.1mV),增加的LAVI (>48ml/m2),中度额头吐和减少的RV-FAC (<35%) 相关.
- 具体指数预测了节律控制失效 (PWD,DTNP-V1,LAVI,心肌反) 和不良事件 (RV-FAC,LAVI,心肌反).
结论:
- 电脑心电图和心声学指数是AF患者中断弗莱卡因的重要预测指标.
- 这些指数与长期使用弗莱卡因治疗的疗效 (节律控制失败) 和安全性 (不良反应) 相相关.
- 对这些参数的治疗前评估可能有助于优化在心房动中使用弗莱卡尼尼德.
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