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改良瓦尔萨尔瓦动作对阵发性室上性心动过速患者的疗效及经济效益

Efficacy and economic benefits of a modified Valsalva maneuver in patients with paroxysmal supraventricular tachycardia.

作者信息

Wang Wei, Jiang Teng-Fei, Han Wei-Zhong, Jin Lin, Zhao Xiao-Jing, Guo Ying

机构信息

Internal Medicine-Cardiovascular Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China.

Department of Nursing, The First Affiliated Hospital of Shandong First Medical University.

出版信息

World J Clin Cases. 2020 Dec 6;8(23):5999-6008. doi: 10.12998/wjcc.v8.i23.5999.

Abstract

BACKGROUND

A modified Valsalva maneuver (VM) has been suggested to be superior to the standard VM for conversion of paroxysmal supraventricular tachycardia (PSVT).

AIM

To evaluate the efficacy and economic benefits of a modified VM in Chinese patients.

METHODS

Patients with PSVT admitted to our center between October 2017 and September 2019 were randomly assigned to the modified and standard VM groups. Conversion VM was performed up to three times. The primary outcome of the study was the success rate of PSVT conversion to sinus rhythm. The secondary outcomes included the incidence of adverse events, economic cost during the visit, and the degree of patient acceptance of the treatment.

RESULTS

Overall, 361 patients were enrolled, with 180 allocated to the modified VM group and 181 to the standard VM group. Baseline characteristics were well matched in the groups. Overall, the modified VM group had higher success rates of PSVT conversion after single (47.78% 15.38%, < 0.001) and multiple (62.22% 19.78%, < 0.001) VM sessions. No significant differences in the incidences of adverse events and rates of patient acceptance were detected between the two groups (both > 0.05). Moreover, the economic cost of the clinic visit was significantly lower for the modified VM group than for the standard VM group ( < 0.05).

CONCLUSION

The modified VM may confer both therapeutic and economic benefits as compared with the standard VM for conversion of PSVT.

摘要

背景

有人提出改良的瓦尔萨尔瓦动作(VM)在阵发性室上性心动过速(PSVT)转复方面优于标准VM。

目的

评估改良VM在中国患者中的疗效和经济效益。

方法

将2017年10月至2019年9月入住本中心的PSVT患者随机分为改良VM组和标准VM组。转复VM最多进行3次。本研究的主要结局是PSVT转复为窦性心律的成功率。次要结局包括不良事件发生率、就诊期间的经济成本以及患者对治疗的接受程度。

结果

总体而言,共纳入361例患者,其中180例分配至改良VM组,181例分配至标准VM组。两组的基线特征匹配良好。总体而言,改良VM组单次(47.78% 对15.38%,P<0.001)和多次(62.22% 对19.78%,P<0.001)VM操作后PSVT转复成功率更高。两组之间不良事件发生率和患者接受率均未检测到显著差异(均P>0.05)。此外,改良VM组的门诊经济成本显著低于标准VM组(P<0.05)。

结论

与标准VM相比,改良VM在PSVT转复方面可能具有治疗和经济效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c7e/7723698/85b1e01f111f/WJCC-8-5999-g001.jpg

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