Kawaji Tetsuma, Shizuta Satoshi, Yaku Hidenori, Kaneda Kazuhisa, Yoneda Fumiya, Nishiwaki Shushi, Tanaka Munekazu, Aizawa Takanori, Hojo Shun, Nakatsuma Kenji, Kato Masashi, Yokomatsu Takafumi, Miki Shinji, Ono Koh, Kimura Takeshi
Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
PLoS One. 2024 Aug 1;19(8):e0307854. doi: 10.1371/journal.pone.0307854. eCollection 2024.
Early arrhythmia recurrences commonly occur after atrial fibrillation (AF) ablation because of irritability and inflammation of left atrium. We hypothesized that short-term use of Saireito would be effective in reducing frequent atrial tachyarrhythmias in the early-phase post-ablation.
One hundred patients undergoing catheter ablation for symptomatic AF were randomly assigned to either a 30-day use of Saireito or control group. The primary endpoint was total number of episodes of frequent atrial tachyarrhythmias including definite recurrent AF and frequent premature atrial contractions during the 30-day treatment period post-ablation.
Three (6.0%) out of 50 patients treated with Saireito discontinued the drug because of adverse symptoms. The Saireito group was associated with a numerically lower number of episodes of frequent atrial tachyarrhythmias than the control group (3.1 versus 5.2 times, P = 0.17). The mean daily episodes of frequent atrial tachyarrhythmias were significantly fewer in the Saireito group during Day-6 to Day-10 (0.12/day versus 0.27/day, P = 0.03), and during Day-11 to Day-15 (0.08/day versus 0.24/day, P = 0.001). The prevalence of adverse symptoms during the 30-day treatment period was significantly higher in the Saireito group (18.0% versus 2.0%, P = 0.005).
Thirty-day use of Saireito following AF ablation was associated with a tendency toward reduced number of episodes of frequent atrial tachyarrhythmias during the treatment period, with more pronounced effect in the first two weeks.
由于左心房的易激性和炎症,心房颤动(AF)消融术后早期心律失常复发很常见。我们假设短期使用柴苓汤对减少消融术后早期频繁发作的房性快速性心律失常有效。
100例因症状性AF接受导管消融的患者被随机分为30天使用柴苓汤组或对照组。主要终点是消融术后30天治疗期内频繁发作的房性快速性心律失常发作总数,包括明确的复发性AF和频繁的房性早搏。
50例接受柴苓汤治疗的患者中有3例(6.0%)因不良症状停药。柴苓汤组频繁发作的房性快速性心律失常发作次数在数值上低于对照组(3.1次对5.2次,P = 0.17)。在第6天至第10天期间,柴苓汤组频繁发作的房性快速性心律失常平均每日发作次数显著较少(0.12次/天对0.27次/天,P = 0.03),在第11天至第15天期间也是如此(0.08次/天对0.24次/天,P = 0.001)。在30天治疗期内,柴苓汤组不良症状的发生率显著更高(18.0%对2.0%,P = 0.005)。
AF消融术后30天使用柴苓汤与治疗期内频繁发作的房性快速性心律失常发作次数减少的趋势相关,在前两周效果更明显。