阜外医院姚焰等研究称,部分房颤消融术后房扑应**索他洛尔!

2020-02-26 胡志成,郑黎晖,赵明昊,等 中国循环杂志

房颤导管消融术后房扑在临床上较为常见,通常积极行二次导管消融术。

房颤导管消融术后房扑在临床上较为常见,通常积极行二次导管消融术。

此外,国外相关专家共识和我国房颤治疗指南均建议房颤导管消融术后早期常规给予抗心律失常药物,不过对于肺静脉传导恢复相关房扑患者,哪种药物能更有效抑制二次导管消融术后复发?

阜外医院姚焰、胡志成等进行的研究通过比较索他洛尔、胺碘酮、普罗帕酮发现,口服索他洛尔效果不错。

研究显示,在平均随访3.7年,房性快速性心律失常复发率为 15.3%。

索他洛尔组术后房性快速性心律失常复发率(6.4%)低于胺碘酮组(10.3%)、普罗帕酮组(23.8%)及空白组(20.6%),与后两者相比差异显着。

而胺碘酮组与普罗帕酮组虽复发率低,但与空白组相比差异均无统计学意义。

此外,在实际临床工作中,较高的不良反应发生率限制了胺碘酮的推广,而普罗帕酮由于存在负性肌力作用,因此并不适合应用于缺血性心脏病、心功能不良和明显左心室肥厚的患者,阻碍了该药的广泛应用。

而在儿童以及胎儿的房扑治疗中,索他洛尔因被认为更加安全和有效而得以应用。

基于一系列研究结果,研究者认为,可以考虑将索他洛尔作为肺静脉传导恢复相关房扑导管消融术后的首选用药。

这项研究选取 2015年1月至2017年12月期间,心房颤动(房颤)消融术后新发房扑、于阜外医院行二次消融术,术中明确房扑为肺静脉传导恢复相关且达消融终点的患者261例。

根据二次消融术后早期口服抗心律失常药物分为索他洛尔组(n=78)、胺碘酮组(n=39)、普罗帕酮组(n=42)和空白组(n=102)四组。

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    2020-02-26 心介

    房颤,临床上碰到很多哦

    0

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