Chronic atrial fibrillation: a systematic review of medical heart rate control management
Chronic atrial fibrillation: a systematic review of medical heart rate control management
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慢性心房颤动：医学心率控制管理的系统回顾
DOI：
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发表时间：
2009
影响因子：
5.1
通讯作者：
K. Channer
中科院分区：
文献类型：
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作者：
T. Nikolaidou;K. Channer
目的：美国国家卫生与临床卓越研究所（NICE）和美国心脏病学会/美国心脏协会/欧洲心脏病学会（ACC/AHA/ESC）关于慢性心房颤动的速率控制管理的最新指南已将地高辛降级为二线治疗，推荐使用β受体阻滞剂或限速钙拮抗剂作为一线治疗。本综述的目的是评估这些药物在控制心率、改善症状和运动耐受性方面的功效。数据来源：电子检索Medline， Embase和Cochrane数据库，手工检索期刊和相关参考书目。研究选择：我们纳入了所有评估或比较口服地高辛、β受体阻滞剂和钙拮抗剂单独或联合用于慢性房颤发病率控制的研究设计。46项研究符合我们的纳入标准和质量标准。结果：已发表的研究规模小且异质性太大，无法进行定量结合。描述性综合数据显示，很少有证据表明β受体阻滞剂或钙拮抗剂单药治疗可改善慢性房颤患者的症状或运动能力。相反，它与剂量相关的副作用有关。结论：根据现有的有限数据，我们得出结论，地高辛联合β受体阻滞剂或钙拮抗剂应作为慢性房颤患者的一线治疗。
Objective: Recent guidelines by the National Institute for Health and Clinical Excellence (NICE) and the American College of Cardiology/American Heart Association/European Society of Cardiology (ACC/AHA/ESC) on rate control management for chronic atrial fibrillation have relegated digoxin to second line treatment, recommending instead the use of β-blockers or rate limiting calcium antagonists as first line treatment. The objective of this review is to assess the efficacy of these drugs in controlling heart rate, and in improving symptoms and exercise tolerance. Data sources: We electronically searched the Medline, Embase and Cochrane databases, hand searched journals and relevant bibliographies for articles. Selection of studies: We included all study designs evaluating or comparing oral digoxin, β-blockers and calcium antagonists, alone or in combination, for rate control in chronic atrial fibrillation. 46 studies satisfied our inclusion and quality criteria. Results: Published studies are small and too heterogeneous to be quantitatively combined. Descriptive synthesis of the data shows little evidence that monotherapy with β-blockers or calcium antagonists improves symptoms or exercise capacity in patients with chronic atrial fibrillation. Instead it is associated with dose related side effects. Conclusion: Based on the limited data available, we conclude that the combination of digoxin with either a β-blocker or calcium antagonist should be first line management in patients with chronic atrial fibrillation.
影响因子：
24
作者：
Olshansky, B;Rosenfeld, LE;Greene, HL
通讯作者：
Greene, HL