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溶栓治疗对肺栓塞的长期抗心律失常作用

Long-Term Antiarrhythmic Effects of Thrombolytic Therapy in Pulmonary Embolism.

作者信息

Hayıroğlu Mert İlker, Keskin Muhammed, Uzun Ahmet Okan, Tekkeşin Ahmet İlker, Avşar Şahin, Öz Ahmet, Yıldırımtürk Özlem, Güngör Barış, Çinier Göksel, Alper Ahmet Taha

机构信息

Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital.

Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital.

出版信息

Heart Lung Circ. 2017 Oct;26(10):1094-1100. doi: 10.1016/j.hlc.2016.11.016. Epub 2017 Jan 24.

Abstract

BACKGROUND

The role of thrombolytic therapy in acute pulmonary embolism patients is still controversial considering the occurrence of arrhythmias. Short-term effects of thrombolytics are well-known whereas long-term effects on cardiac electrophysiology have not been reported before. The objective of our study was to assess the arrhythmic differences in pulmonary embolism patients who received thrombolytics followed by anticoagulation or anticoagulation alone.

METHODS

Sixty patients who received thrombolytic therapy followed by anticoagulation (group 1) and 60 patients who received anticoagulation alone (group 2) were included in this retrospective, single-centre observational study. Twenty-four-hour ambulatory electrocardiography was performed 31 ± 9 months after pulmonary embolism hospitalisation in order to compare arrhythmias originating from both ventricles and atria.

RESULTS

The age and gender distribution of the patients were statistically similar. Ventricular arrhythmias were found to be the same between t-PA and non t-PA groups. All types of atrial arrhythmias were found to be increased in non t-PA group even though left and right atrial volume indexes were statistically identical between the two groups.

CONCLUSION

In long-term pulmonary embolism, follow-up thrombolytic therapy was demonstrated to have atrial antiarrhythmic effects.

摘要

背景

考虑到心律失常的发生,溶栓治疗在急性肺栓塞患者中的作用仍存在争议。溶栓药物的短期效果已为人熟知,但其对心脏电生理的长期影响此前尚未见报道。我们研究的目的是评估接受溶栓治疗后抗凝或单纯抗凝的肺栓塞患者的心律失常差异。

方法

本回顾性单中心观察性研究纳入了60例接受溶栓治疗后抗凝的患者(第1组)和60例单纯接受抗凝的患者(第2组)。在肺栓塞住院31±9个月后进行24小时动态心电图检查,以比较源自心室和心房的心律失常情况。

结果

患者的年龄和性别分布在统计学上相似。发现t-PA组和非t-PA组之间室性心律失常情况相同。尽管两组之间左、右心房容积指数在统计学上相同,但非t-PA组中所有类型的房性心律失常均有所增加。

结论

在长期肺栓塞中,随访发现溶栓治疗具有心房抗心律失常作用。

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