在患有心房动的患者早期节律控制治疗中的心率
Tim Koldenhof1,2, Katrin Borof3, Isabelle C Van Gelder2
1Department of Cardiology, Martini Hospital, Groningen, The Netherlands.
Heart (British Cardiac Society)
|February 9, 2026
概括
建议在心房动 (AF) 中预防高心率,但这项研究发现,心率低于或高于每分钟110次的患者之间心血管事件没有差异. 早期节律控制改善了结果,无论基线心率如何.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 在心房的管理管理.
背景情况:
- 目前的指导方针建议在心房动 (AF) 中控制高心率,以减轻症状和发病率.
- 然而,强有力的证据将AF期间心率降低与症状减少或心血管并发症联系在一起是有限的.
研究的目的:
- 为了研究基线心率 (<110 bpm vs. ≥110 bpm) 与AF相关症状,治疗策略和主要心血管不良事件之间的关系.
- 评估早期节律控制对AF期间基线心率变化的患者的结果的影响.
主要方法:
- 对心房的早期治疗以预防中风的分析 试验数据.
- 在基线心率<110 bpm和≥110 bpm的患者之间比较症状负担和复合心血管结果.
- 主要结局的评估:心血管死亡,中风或因心力衰竭/急性冠状动脉综合征住院的组合.
主要成果:
- 在基线心率≥110bpm的患者报告了比心率较低的患者更频繁和严重的AF症状 (78%对62%,p<0.001).
- 在两组心率组之间,初级复合心血管结局率没有显著差异 (HR1.08,95% CI 0.79至1.48).
- 早期节律控制策略在降低高和低基线心率组的不良结果方面显示出好处.
结论:
- 在AF中心率升高 (≥110 bpm) 与症状严重程度增加相关,但与较高的心血管事件率无关.
- 心血管事件发生率在AF期间心率低 (<110 bpm) 和高 (≥110 bpm) 的患者之间是可比的.
- 早期节律控制是一种有效的策略,可以改善AF患者的结果,无论他们的心率如何.
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