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晚期心衰患者常有房颤。但房颤的预后意义仍有争议。本文对连续390例晚期心衰患者的房律与总存活率以及猝死的关系进行评价。其中冠心病177例,非缺血性心肌病和瓣膜性心脏病213例。左室射血分数为0.19±0.07。75例具有阵发性(26例)或慢性(49例)房颤。房颤患者同窦性心律的患者相比,较多接受华法林和抗心律失常药物治疗,左室射血分数略高;但在病因、治疗时的平均肺楔压及栓塞情况均无显著差异。随访236±306天,98例死亡。其中56例猝死,36例死于进行性心衰。保险统计表明,1
Patients with advanced heart failure often have atrial fibrillation. However, the prognostic significance of atrial fibrillation is still controversial. This article evaluates the relationship between atrial and total survival and sudden death in 390 consecutive patients with advanced heart failure. 177 cases of coronary heart disease, non-ischemic cardiomyopathy and valvular heart disease in 213 cases. Left ventricular ejection fraction was 0.19 ± 0.07.75 cases had paroxysmal (26 cases) or chronic (49 cases) atrial fibrillation. Compared with patients with sinus rhythm, patients with atrial fibrillation received warfarin and antiarrhythmic drugs more often and their left ventricular ejection fraction was slightly higher. However, there was no significant difference in mean pulmonary wedge pressure and embolism difference. Followed up for 236 ± 306 days, 98 patients died. 56 cases of sudden death, 36 died of progressive heart failure. Insurance statistics show that 1