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急诊科对妊娠患者室上性快速心律失常的处理

Managing supraventricular tachyarrhythmia in pregnant patients within the emergency department.

作者信息

Pan Di, Chen Zhongqing, Chen Haibo

机构信息

Department of Cardiology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.

Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.

出版信息

Front Cardiovasc Med. 2024 Dec 10;11:1517990. doi: 10.3389/fcvm.2024.1517990. eCollection 2024.

Abstract

BACKGROUND

Pregnancy increases the risk of supraventricular tachycardia (SVT) due to physiological changes. This study reviews the management of SVT in pregnant patients in the emergency department (ED).

METHODS

We retrospectively analyzed 15 pregnant patients with SVT treated at Shenzhen Second People's Hospital ED from 2015 to 2023. Treatments included vagal nerve stimulation, pharmacotherapy, esophageal pacing, cardioversion, and radiofrequency ablation.

RESULTS

The average patient age was 30.3 years. All presented with palpitations, and none had hemodynamic instability. Treatment success varied: 3 patients reverted spontaneously, 5 responded to vagal stimulation, and 4 to esophageal pacing. One required verapamil, and another responded to labetalol after failing vagal and pacing treatments.

CONCLUSION

When managing SVT during pregnancy, it is important to consider the patient's stability, the stage of pregnancy, and the safety of medications. For unstable patients, electrical cardioversion is the preferred option; for stable patients, vagus nerve stimulation (VNS) or other alternative treatments, such as adenosine, should be considered.

摘要

背景

由于生理变化,怀孕会增加室上性心动过速(SVT)的风险。本研究回顾了急诊科(ED)对妊娠患者室上性心动过速的处理。

方法

我们回顾性分析了2015年至2023年在深圳市第二人民医院急诊科治疗的15例妊娠合并室上性心动过速患者。治疗方法包括迷走神经刺激、药物治疗、食管起搏、心脏复律和射频消融。

结果

患者平均年龄为30.3岁。所有患者均有心悸症状,无一例出现血流动力学不稳定。治疗成功率各不相同:3例患者自行恢复,5例对迷走神经刺激有反应,4例对食管起搏有反应。1例需要维拉帕米治疗,另1例在迷走神经刺激和起搏治疗失败后对拉贝洛尔有反应。

结论

在处理妊娠期室上性心动过速时,重要的是要考虑患者的稳定性、妊娠阶段和药物安全性。对于不稳定患者,电复律是首选;对于稳定患者,应考虑迷走神经刺激(VNS)或其他替代治疗,如腺苷。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7af7/11666441/f47b06fa1cfb/fcvm-11-1517990-g001.jpg

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