心房颤动复律前后的功能能力：一项对照研究。
Functional capacity before and after cardioversion of atrial fibrillation: a controlled study.
作者信息
Gosselink A T, Crijns H J, van den Berg M P, van den Broek S A, Hillege H, Landsman M L, Lie K I
机构信息
Department of Cardiology, University Hospital Groningen, Groningen, The Netherlands.
出版信息
Br Heart J. 1994 Aug;72(2):161-6. doi: 10.1136/hrt.72.2.161.
OBJECTIVE
To evaluate the effect of cardioversion on peak oxygen consumption (peak VO2) in patients with long-standing atrial fibrillation, to assess the importance of underlying heart disease with respect to the response to exercise, and to relate functional capacity to long-term arrhythmia outcome.
DESIGN
Prospective controlled clinical trial.
SETTING
Tertiary referral centre.
PATIENTS
63 consecutive patients with chronic atrial fibrillation accepted for treatment with electrical cardioversion. Before cardioversion all patients were treated with digoxin, verapamil, or a combination of both to attain a resting heart rate < or = 100 beats per minute.
INTERVENTIONS
Electrical cardioversion.
MAIN OUTCOME MEASURES
Peak VO2 measured before and 1 month after electrical cardioversion to compare patients who were in sinus rhythm and those in atrial fibrillation at these times. Maintenance of sinus rhythm for a mean follow up of 19 (7) months.
RESULTS
Mean (1SD) peak VO2 in patients in sinus rhythm after 1 month (n = 37) increased from 21.4 (5.8) to 23.7 (6.4) ml/min/kg (+11%, P < 0.05), whereas in patients with a recurrence of atrial fibrillation 1 month after cardioversion (n = 26) peak VO2 was unchanged. In patients who were in sinus rhythm both those with and without underlying heart disease improved, and improvement was not related to functional capacity or left ventricular function before cardioversion. Baseline peak VO2 was not a predictive factor for long-term arrhythmia outcome.
CONCLUSION
Restoration of sinus rhythm improved peak VO2 in patients with atrial fibrillation, irrespective of the presence of underlying heart disease. Peak VO2 was not a predictive factor for long-term arrhythmia outcome after cardioversion of atrial fibrillation. These findings suggest that cardioversion is the best method of improving functional capacity in patients with atrial fibrillation, whether or not they have underlying heart disease and whatever their functional state.
目的
评估心脏复律对长期持续性房颤患者峰值摄氧量（peak VO2）的影响，评估基础心脏病对运动反应的重要性，并将功能能力与长期心律失常结局相关联。
设计
前瞻性对照临床试验。
地点
三级转诊中心。
患者
63例连续接受电复律治疗的慢性房颤患者。复律前，所有患者均接受地高辛、维拉帕米或两者联合治疗，以使静息心率≤100次/分钟。
干预措施
电复律。
主要观察指标
在电复律前及复律后1个月测量peak VO2，以比较此时处于窦性心律和房颤的患者。平均随访19（7）个月维持窦性心律情况。
结果
1个月后处于窦性心律的患者（n = 37）平均（1SD）peak VO2从21.4（5.8）增加至23.7（6.4）ml/min/kg（增加11%，P < 0.05），而在复律后1个月房颤复发的患者（n = 26）中peak VO2未改变。在处于窦性心律的患者中，无论有无基础心脏病均有改善，且改善与复律前的功能能力或左心室功能无关。基线peak VO2不是长期心律失常结局的预测因素。
结论
恢复窦性心律可改善房颤患者的peak VO2，无论是否存在基础心脏病。peak VO2不是房颤复律后长期心律失常结局的预测因素。这些发现表明，无论房颤患者是否有基础心脏病以及其功能状态如何，复律都是改善其功能能力的最佳方法。
Zotero 插件