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保持“时效性”:治疗室上性心动过速的方法综述。

Keeping It "Current": A Review of Treatment Options for the Management of Supraventricular Tachycardia.

机构信息

Department of Pharmacy, Ascension Resurrection Medical Center, Chicago, IL, USA.

Department of Pharmacy, Loyola University Medical Center, Maywood, IL, USA.

出版信息

Ann Pharmacother. 2024 Jul;58(7):715-727. doi: 10.1177/10600280231199136. Epub 2023 Sep 24.

Abstract

OBJECTIVE

To review treatment options and updates that exist for the management of paroxysmal supraventricular tachycardia (PSVT).

DATA SOURCES

A literature search of PubMed was performed including articles from 1974 to June 2023 using the terms: , , , , , , , , , , , , , , , . Primary literature and guidelines were reviewed.

STUDY SELECTION AND DATA EXTRACTION

Studies were considered if they were available in English and conducted in humans.

DATA SYNTHESIS

PSVT is a subset of supraventricular tachycardia (SVT) that presents as a rapid, regular tachycardia with an abrupt onset and termination. Due to frequent emergency department (ED) visits annually with symptoms of PSVT, appropriate and efficient management of these patients is vital. This review provides an overview of the pathophysiology of PSVT, while also describing the literature behind nonpharmacologic and pharmacologic management of PSVT.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE

This review describes new literature regarding the improved success of the modified Valsalva maneuver as a nonpharmacologic therapy in PSVT. In addition, it describes a new technique in administration of adenosine that has improved outcomes, defines dose adjustments needed for drug interactions with adenosine, compares the utilization of nondihydropyridine calcium channel blockers with adenosine, and provides management recommendations for patients in special populations.

CONCLUSIONS

With high annual rates of ED visits for SVT, providers should be aware of the data behind management and modifications of therapy based on patient-specific factors (ie, patient preference, pharmacokinetics/pharmacodynamics, drug interactions, and special populations).

摘要

目的

综述阵发性室上性心动过速(PSVT)治疗选择和最新进展。

资料来源

通过PubMed 进行文献检索,检索词包括:,,,,,,,,,,,,,, 。检索了 1974 年至 2023 年 6 月的文章,同时还回顾了主要文献和指南。

研究选择和数据提取

如果研究为英文且为人体研究,则纳入分析。

资料综合

PSVT 是室上性心动过速(SVT)的一个子集,表现为快速、规则的心动过速,具有突然发作和终止的特点。由于每年因 PSVT 症状而频繁到急诊科就诊,因此对这些患者进行适当和有效的管理至关重要。本综述概述了 PSVT 的病理生理学,同时还描述了非药物和药物治疗 PSVT 的文献依据。

临床意义

本综述描述了改良瓦氏动作作为 PSVT 非药物治疗的成功率提高的新文献。此外,它还描述了腺苷给药的新技术,该技术提高了疗效,定义了与腺苷相互作用时所需的剂量调整,比较了非二氢吡啶类钙通道阻滞剂与腺苷的应用,并为特殊人群患者提供了管理建议。

结论

由于 SVT 的急诊科就诊率很高,因此临床医生应该了解治疗管理和调整背后的数据,这些数据应基于患者的具体情况(即患者偏好、药代动力学/药效学、药物相互作用和特殊人群)。

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