孕期心脏结构正常的心房颤动：当前实践的国际调查。
Atrial fibrillation with a structurally normal heart in pregnancy: An international survey on current practice.
作者信息
Cumyn Annabelle, Sauvé Nadine, Rey Évelyne
机构信息
Department of Medicine, Faculté de Médecine et des Sciences de la santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, Canada.
出版信息
Obstet Med. 2017 Jun;10(2):74-78. doi: 10.1177/1753495X16685684. Epub 2017 Jan 29.
BACKGROUND
Little evidence exists for the optimal management of atrial fibrillation with a structurally normal heart in pregnancy.
METHODS
A survey was sent to members of two associations to obtain input on optimal management of atrial fibrillation in pregnancy. The survey presented four cases with respect to (1) baseline investigations; (2) rate versus rhythm control; (3) chemical versus electrical cardioversion; and (4) anticoagulation.
RESULTS
Sixty-one responders from 11 countries participated. High agreement was noted for baseline investigations. A quarter (25%) of participants chose elective cardioversion even with a reversible precipitant. Electrical cardioversion was preferred over chemical ( < 0.05). Anticoagulation strategies were heterogeneous except in the presence of a left atrial appendage thrombus.
DISCUSSION
This study revealed that there was little consensus in current practice in pregnancy beyond basic investigations. An adaptation of established guidelines to the pregnant population would require a meeting of Cardiologists with input from colleagues in Obstetric Medicine.
背景
关于孕期心脏结构正常的心房颤动的最佳管理，几乎没有证据。
方法
向两个协会的成员发送了一项调查，以获取有关孕期心房颤动最佳管理的意见。该调查针对（1）基线检查；（2）心率控制与节律控制；（3）药物复律与电复律；以及（4）抗凝提出了四个病例。
结果
来自11个国家的61名受访者参与了调查。在基线检查方面达成了高度共识。四分之一（25%）的参与者即使有可逆性诱因也选择择期复律。电复律优于药物复律（P<0.05）。除存在左心耳血栓外，抗凝策略存在异质性。
讨论
本研究表明，除了基本检查外，目前孕期实践中几乎没有共识。将既定指南适用于孕妇群体需要心脏病专家与妇产科同事共同商讨。
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