Int J Cardiol:持续性心房颤动患者微创手术消融分析

2018-12-01 xing.T MedSci原创

在持续性AF患者中,微创手术消融发生手术并发症更多,但无AF发作时间比例更高。由于手术消融后的不良事件比导管消融更严重,因此需要选择适合患者的治疗方案。

持续性心房颤动(AF)与阵发性房颤(pAF)相比,卒中和死亡风险更高。持续性AF患者的导管或手术消融结果比pAF患者更差,并且尚未明确最佳的有创性节律控制策略。近日,血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章,研究人员对导管的功效和安全性以及持续性AF的微创手术消融进行了系统概述。

研究人员系统地检索了EMBASE、MEDLINE和CENTRAL数据库,检索时间从数据库成立到2018年7月,确定了接受手术和导管消融治疗的随机试验。该研究的结局没有使用AAD的情况下随访超过12个月的无AF发作时间。随机效应模型用于计算95%置信区间的比例。安全性结局包括治疗期间和随访期间的不良事件。

研究人员纳入了6项关于微创手术消融的研究以及56项导管消融的研究,涉及7624例持续性AF患者。手术后12个月无AF发作时间比例为69%(95%CI为64-74%),导管消融后为51%(95%CI为46-56%)。手术比导管消融出现了更严重的操作相关的不良事件。

在持续性AF患者中,微创手术消融发生手术并发症更多,但无AF发作时间比例更高。由于手术消融后的不良事件比导管消融更严重,因此需要选择适合患者的治疗方案。

原始出处:

Wouter R.Berger,et al. Persistent atrial fibrillation: A systematic review and meta-analysis of invasive strategies.International Journal of Cardiology.2018. https://doi.org/10.1016/j.ijcard.2018.11.127

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    2018-12-03 vera_1203
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    2018-12-03 sodoo
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    2018-12-01 医者仁心5538

    学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1922586, encodeId=f004192258637, content=<a href='/topic/show?id=3f3156324ff' target=_blank style='color:#2F92EE;'>#持续性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56324, encryptionId=3f3156324ff, topicName=持续性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Fri May 31 05:27:00 CST 2019, time=2019-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1781980, encodeId=d85c1e8198056, content=<a href='/topic/show?id=5db8409ed8' target=_blank style='color:#2F92EE;'>#Cardiol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4097, encryptionId=5db8409ed8, topicName=Cardiol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Fri Jul 12 10:27:00 CST 2019, time=2019-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309484, encodeId=03dc1309484c0, content=<a href='/topic/show?id=64ee5052ea7' target=_blank style='color:#2F92EE;'>#微创手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50527, encryptionId=64ee5052ea7, topicName=微创手术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Mon Dec 03 02:27:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317039, encodeId=0843131e0392b, content=<a href='/topic/show?id=df8950505a2' target=_blank style='color:#2F92EE;'>#微创#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50505, encryptionId=df8950505a2, topicName=微创)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Mon Dec 03 02:27:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421753, encodeId=45711421e53ce, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Mon Dec 03 02:27:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626898, encodeId=c54816268983d, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon Dec 03 02:27:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354187, encodeId=ad6e35418eaf, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Dec 01 13:51:45 CST 2018, time=2018-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354177, encodeId=306f3541e79d, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=ebe61630855, createdName=1dd8a7c5m95(暂无匿称), createdTime=Sat Dec 01 12:28:20 CST 2018, time=2018-12-01, status=1, ipAttribution=)]
    2018-12-01 1dd8a7c5m95(暂无匿称)

    好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!

    0

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