High serum potassium level is associated with successful electrical cardioversion for new-onset atrial fibrillation in the intensive care unit: A retrospective observational study
High serum potassium level is associated with successful electrical cardioversion for new-onset atrial fibrillation in the intensive care unit: A retrospective observational study
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DOI：
10.1177/0310057x18811815
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发表时间：
2019-01-01
影响因子：
1.5
通讯作者：
Shime, Nobuaki
中科院分区：
文献类型：
--
作者：
Kyo, Michihito;Hosokawa, Koji;Shime, Nobuaki
电复律 (ECV) 是治疗血流动力学不稳定的新发房颤 (AF) 的一种可能挽救生命的治疗方法；然而，其功效并不令人满意。我们的目的是阐明与 AF 患者成功 ECV 和预后相关的因素。这项回顾性观察研究是在一所大学医院的两个混合重症监护病房 (ICU) 中进行的。纳入在 ICU 接受 ECV 的新发 AF 患者。我们将 ECV 时段定义为 15 分钟内的连续冲击。 ECV 的成功与否在课程结束五分钟后进行评估。我们分析了与成功 ECV 和 ICU 死亡率相关的因素。其中包括 85 名接受 ECV 治疗的 AF 患者。 41 名 (48%) 患者 ECV 成功，11 名患者 (13%) 维持窦性心律直至出院 ICU。在多变量分析中，血清钾水平 >= 3.8 mol/L 与成功的 ECV 独立相关（比值比 (OR)，3.13；95% 置信区间 (CI)，1.07-9.11；p = 0.04）。维持窦性心律直至 ICU 出院与 ICU 存活率显着相关（OR 9.35；95% CI 1.02-85.78，p = 0.048）。 ECV 在 ICU 内发生的新发 AF 患者中 48% 取得成功。血清钾水平>= 3.8 mol/L与成功ECV独立相关，维持窦性心律直至ICU出院与ICU存活率独立相关。这些结果表明，在考虑 ICU 中 ECV 对 AF 的有效性时，保持较高的血清钾水平可能很重要。
Electrical cardioversion (ECV) is a potentially life-saving treatment for haemodynamically unstable new-onset atrial fibrillation (AF); however, its efficacy is unsatisfactory. We aimed to elucidate the factors associated with successful ECV and prognosis in patients with AF. This retrospective observational study was conducted in two mixed intensive care units (ICUs) in a university hospital. Patients with new-onset AF who received ECV in the ICU were enrolled. We defined an ECV session as consecutive shocks within 15 minutes. The success of ECV was evaluated five minutes after the session. We analysed the factors associated with successful ECV and ICU mortality. Eighty-five AF patients who received ECV were included. ECV was successful in 41 (48%) patients, and 11 patients (13%) maintained sinus rhythm until ICU discharge. A serum potassium level >= 3.8 mol/L was independently associated with successful ECV in multivariate analysis (odds ratio (OR), 3.13; 95% confidence interval (CI), 1.07-9.11; p = 0.04). Maintenance of sinus rhythm until ICU discharge was significantly associated with ICU survival (OR 9.35; 95% CI 1.02-85.78, p = 0.048). ECV was successful in 48% of patients with new-onset AF developed in the ICU. A serum potassium level >= 3.8 mol/L was independently associated with successful ECV, and sinus rhythm maintained until ICU discharge was independently associated with ICU survival. These results suggested that maintaining a high serum potassium level may be important when considering the effectiveness of ECV for AF in the ICU.