对心房的侵略性降低风险因子研究对废除结果的影响:ARREST-AF随机临床试验
Rajeev K Pathak1,2, Adrian D Elliott1, Dennis H Lau1
1Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
JAMA cardiology
|October 29, 2025
概括
积极的生活方式和风险因素管理显著减少了导管切除后心房 (AF) 的复发. 这种方法对于在患有高BMI和心脏代谢风险因素的患者中,在切除后维持鼻节律至关重要.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 预防医学 预防医学
背景情况:
- 随着时间的推移,心房动 (AF) 除结果往往会下降.
- 观察性研究表明,改变生活方式可以改善结果,但随机试验证据有限.
研究的目的:
- 评估风险因素和体重管理对AF切除后维持鼻节律的影响.
主要方法:
- 一个多中心的随机临床试验,涉及122名患有症状性AF,BMI升高 (≥27) 和心脏代谢风险因素的患者.
- 患者被随机分配到生活方式和风险因素管理 (LRFM) 或常规护理 (UC) 进行12个月的抽取后治疗.
主要成果:
- 在LRFM组显示了显著更高的比例的患者在12个月没有AF (61.3%对40%,P=.03).
- 慢性心律失常导致心律失常复发风险降低了47%,并显著改善了AF症状严重程度,体重,腰围和缩血压.
结论:
- 积极的风险因素管理有效地减少AF导管切除后心律失常的复发.
- 这一策略对于患有AF,肥胖和心脏代谢风险因素的患者的长期节律控制至关重要.
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