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NEJM:导管消融除颤可显著改善房颤伴心力衰竭患者预后

2018-02-01 zhangfan MedSci原创

研究认为,对于房颤伴心力衰竭患者,在现有治疗指南的基础上进行房颤导管消融术可降低患者心衰导致的死亡或住院风险

房颤伴心力衰竭患者的死亡率显著高于单纯性心力衰竭患者,对于正在接受治疗的房颤伴心力衰竭患者,导管消融房颤治疗是一种潜在的预后改善手段。

近日研究人员随机招募抗心律失常药物无效的、有症状的阵发性或持续性房颤患者,在现行指南基础上随机接受房颤导管消融术(n=179)或药物治疗(频率或节律控制,n=184)。所有患者符合纽约心脏协会II-IV级心力衰竭、左心室射血分数35%或以下并植入除颤器。研究的主要终点是因心力衰竭恶化住院或死亡的复合终点。

研究中位随访37.8个月。导管消融组较药物治疗组主要终点的发生率较低(51例 [28.5%] vs 82 例 [44.6%];HR,0.62; 95%,CI,0.43-0.87;P=0.007)。导管消融组死亡率(24例 [13.4%] vs 46例 [25.0%];HR,0.53;95% CI,0.32-0.86;P=0.01)、心衰恶化住院率(37例 [20.7%] vs 66例 [35.9%];HR,0.56;95% CI,0.37-0.83;P=0.004)以及心血管死亡率(20例 [11.2%] vs 41例 [22.3%];HR,0.49;95% CI,0.29-0.84; P=0.009)较低。

研究认为,对于房颤伴心力衰竭患者,在现有治疗指南的基础上进行房颤导管消融术可降低患者心衰导致的死亡或住院风险。

原始出处:

Nassir F. Marrouche et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med. February 1 2018.

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    2018-02-03 zhouqu_8
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    2018-02-02 戒馋,懒,贪

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