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首页> 外文期刊>Journal of Clinical Medicine Research >High Prevalence of Proarrhythmic Events in Patients With History of Atrial Fibrillation Undergoing a Rhythm Control Strategy: A Retrospective Study
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High Prevalence of Proarrhythmic Events in Patients With History of Atrial Fibrillation Undergoing a Rhythm Control Strategy: A Retrospective Study

机译：房颤史的患者心律失常事件的高发生率的心律控制策略：一项回顾性研究。

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Background: A retrospective study was undertaken to evaluate the respective prevalence of proarrhythmic events depending on various therapeutic regimens within a population of patients with history of atrial fibrillation (AF) undergoing a rhythm control strategy. Methods: Inclusion criterion was the presence of AF in the patient’s clinical history, whose cardioversion had been followed by the adoption of rhythm control strategy. The primary endpoint was the determination of the respective prevalences of paradoxical arrhythmias in the various therapeutic groups. The secondary objective was all-cause mortality. Results: A total of 182 cases of proarrhythmia out of 624 patients were detected during a median follow-up of 20 months (interquartile range: 18 - 24 months). The prevalences of proarrhythmic events were: IC antiarrhythmic drugs + beta-blockers, 111 cases out of a total of 251 patients (44.22%); amiodarone, seven cases out of a total of 230 patients (3%); sotalol, 61 cases out of a total of 140 patients (43.57%); quinidine + digoxin, three cases out of a total of three patients (100%). The paradoxical arrhythmias were: torsades de pointes, second- and third-degree sino-atrial block, slow atrial flutter with 1:1 atrioventricular (AV) conduction, second-degree Mobitz II AV block, and sustained monomorphic ventricular tachycardia. No fatal case of proarrhythmia was found. Conclusions: Secondary prevention of AF relapses by means of drugs suitable for accomplishing rhythm control strategy exposes the patients to incumbent risk of proarrhythmic events. Thus, the choice to avoid some varieties of antiarrhythmics with marked proarrhythmic potential (class IC drugs, sotalol, quinidine) appears to be warranted.
机译：背景：进行了一项回顾性研究，以评估心律失常控制史下有心房颤动（AF）病史的患者群体中各种治疗方案所引起的心律失常事件的患病率。方法：纳入标准为患者的临床病史中存在房颤，其复律后采用心律控制策略。主要终点是确定各个治疗组中反常性心律不齐的患病率。次要目标是全因死亡率。结果：在中位随访20个月（四分位间距：18-24个月）中，在624例患者中总共检测出182例心律失常。心律失常事件的发生率是：IC抗心律失常药物+β受体阻滞剂，共251例患者中的111例（44.22％）;胺碘酮，总计230例患者中有7例（3％）;索他洛尔140例患者中有61例（43.57％）;奎尼丁+地高辛3例中有3例（100％）。矛盾的心律不齐为：尖端扭转型，二度和三度窦房传导阻滞，房室传导（1：1）缓慢房扑，二度Mobitz II AV阻滞和持续性单形室性心动过速。未发现致命的心律失常病例。结论：通过适用于完成心律控制策略的药物对房颤复发进行二级预防，使患者面临心律失常事件的风险。因此，避免使用某些具有明显心律不齐潜力的抗心律失常药物（IC类药物，索他洛尔，奎尼丁）似乎是明智的选择。

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