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首页> 外文期刊>IJC Heart & Vasculature >Rhythm-control therapy for new-onset atrial fibrillation in critically ill patients: A post hoc analysis from the prospective multicenter observational AFTER-ICU study
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Rhythm-control therapy for new-onset atrial fibrillation in critically ill patients: A post hoc analysis from the prospective multicenter observational AFTER-ICU study

机译：危重病患者新出售心房颤动的节奏控制疗法：前瞻性多中心观测后的ICU研究中的后HOC分析

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BackgroundSustained new-onset atrial fibrillation (AF) in the intensive care unit has been reported to be associated with poor outcomes. However, in critical illness, whether rhythm-control therapy can achieve sinus rhythm (SR) restoration is unknown. This study aimed to assess the impact of rhythm-control therapy on SR restoration for new-onset AF in critically ill patients.MethodsThis post-hoc analysis of a prospective multicenter observational study involving 32 Japan intensive care units compared patients with and without rhythm-control therapy for new-onset atrial fibrillation (AF) and conducted a multivariable analysis using Cox proportional hazards regression analysis including rhythm-control therapy as a time-varying covariate for SR restoration.ResultsOf 423 new-onset AF patients, 178 patients (42%) underwent rhythm-control therapy. Among those patients, 131 (31%) underwent rhythm-control therapy within 6?h after AF onset. Magnesium sulphate was the most frequently used rhythm-control drug. The Cox proportional hazards model for SR restoration showed that rhythm-control therapy had a significant positive association with SR restoration (adjusted hazard ratio: 1.46; 95% confidence interval: 1.16–1.85). However, the rhythm-control group had numerically higher hospital mortality than the non-rhythm-control group (31% vs. 23%, p?=?0.09).ConclusionsRhythm-control therapy for new-onset AF in critically ill patients was associated with SR restoration. However, patients with rhythm-control therapy had poorer prognosis, possibly due to selection bias. These findings may provide important insight for the design and feasibility of interventional studies assessing rhythm-control therapy in new-onset AF.
机译：据报道，背景技术在重症监护室中的新出售心房颤动（AF）与差的结果有关。然而，在危重疾病中，无论节奏控制治疗是否可以实现窦性心律（SR）恢复是未知的。本研究旨在评估节律 - 对照治疗对危重患者的新发达AF的恢复对患者的影响。涉及32名日本重症监护单位的前瞻性多中心观测研究的HOC分析，比较了患者，无节奏控制疗法进行新出头心房颤动（AF），并使用Cox比例危害回归分析进行多变量分析，包括节奏控制疗法，作为SR Resorions的时变协变量。423患者，178名患者（42％）接受节律控制疗法。在此患者中，131（31％）在AF发作后在6μm中接受节律 - 对照治疗。硫酸镁是最常用的节奏对照药物。 SR恢复的Cox比例危害模型表明，节奏控制治疗与SR恢复有显着的阳性关系（调整后危险比：1.46; 95％置信区间：1.16-1.85）。然而，节奏对照组的医院死亡率比非节奏对照组（31％对照组，p？= 0.09）。危重病患者在危重病症中的新出售AF控制治疗相关使用SR恢复。然而，有节奏对照治疗的患者预后较差，可能是由于选择偏差。这些发现可以为评估新出售AF中的节律控制治疗的介入研究的设计和可行性提供重要的见解。

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