提高心房除颤器治疗持续性房颤的可接受性:心房除颤器镇静评估研究(ADSAS)  

Improving the acceptability of the atrial defibrillator for the treatment of persistent atrial fibrillation: The atrial defibrillator sedation assessmen t study (ADSAS)

作　　者：Mitchell A.R.J. Spurrell P.A.R. Gerritse B.E.W. Sulke N. 梁磊 

机构地区：[1]Department of Cardiology, Eastbourne General Hospital, Kings Drive, BN21 2UD, Eastb ourne, United Kingdom

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2005年第1期25-26,共2页

摘　　要：Background: To compare the acceptability and effectiveness of three pre -medic ation regimens for manually activated cardioversion of recurrent persistent atri al fibrillation. Methods: Eighteen patients implanted with the Jewel AF atrial d efibrillator for drug-resistant persistent atrial fibrillation only were studie d in an open-labelled randomised crossover study. Patients were assigned to sed ation (S) with midazolam elixir, analgesia(A) with morphine sulphate or combinat ion therapy(C) with dextromoramide and lorazepam. Pre-medication was taken up t o 1h before cardioversion. Patients rotated through each type of medication afte r undertaking at least one cardioversion. Visual analogue scales were completed immediately post-cardiov-ersion and 24 h later for pain, anxiety and ‘unpleas an-tness’. Higher scores represented a worse outcome. Results: After 2 years’ follow-up, 238 cardioversions were performed with S, 17 with A and 35 with C. T he mean immediate combined score for S(10.9, 95%confidence interval(CI) 8.2-13 .6) was significantly lower than for A(17.3,95%CI 15.1-19.5,P=0.01)-and for C (15.9, 95%CI 12.3-19.6, P=0.02). All patients who used S chose it as the most favourable pre-medicant. All patients who used A found it the least acceptable . Conclusion: Sedation rather than analgesia enhanced the acceptability of manua lly activated atrial defibrillation.Background: To compare the acceptability and effectiveness of three pre -medic ation regimens for manually activated cardioversion of recurrent persistent atri al fibrillation. Methods: Eighteen patients implanted with the Jewel AF atrial d efibrillator for drug-resistant persistent atrial fibrillation only were studie d in an open-labelled randomised crossover study. Patients were assigned to sed ation (S) with midazolam elixir, analgesia(A) with morphine sulphate or combinat ion therapy(C) with dextromoramide and lorazepam. Pre-medication was taken up t o 1h before cardioversion. Patients rotated through each type of medication afte r undertaking at least one cardioversion. Visual analogue scales were completed immediately post-cardiov-ersion and 24 h later for pain, anxiety and ‘unpleas an-tness’. Higher scores represented a worse outcome. Results: After 2 years’ follow-up, 238 cardioversions were performed with S, 17 with A and 35 with C. T he mean immediate combined score for S(10.9, 95%confidence interval(CI) 8.2-13 .6) was significantly lower than for A(17.3,95%CI 15.1-19.5,P=0.01)-and for C (15.9, 95%CI 12.3-19.6, P=0.02). All patients who used S chose it as the most favourable pre-medicant. All patients who used A found it the least acceptable . Conclusion: Sedation rather than analgesia enhanced the acceptability of manua lly activated atrial defibrillation.

关 键 词：心房除颤器 ADSAS 持续性房颤 电复律 可接受性 心脏复律 评估研究 劳拉西泮 电除颤 交叉研究 

分 类 号：R541.7[医药卫生—心血管疾病]