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Frumárangur rafvendingar vegna hjartsláttartruflana frá gáttum

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Authors
Davíð O. Arnar,
Ragnar Danielsen
Issue Date
1992-03-01

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Læknablaðið 1992, 78(3):87-93
Abstract
A retrospective analysis was done on 80 patients requiring DC cardioversion for supraventricular arrhythmias during a 4 year period 1986-1989. The group consisted of 62 males and 18 females and the mean ± SD age was 65±10 years. Sixty-one patients converted to sinus rhythm making the initial success rate 76%. Fifty-nine (74%) had atrial fibrillation which was the most common arrhythmia. Coronary heart disease in 25 patients (31%), hypertension in 17 patients (21%) and valvular heart disease in 16 patients (20%) were the most common underlying diseases. Patients with aortic valve disease converted proportionally less often to sinus rhythm, otherwise these disease categories did not influence the outcome of cardioversion. Furthermore, patients who had pulmonary disease had a significantly worse outcome from cardioversion. Heart size on chest X-ray did not significantly influence the outcome of cardioversion. Digoxin and quinidine were the most common drugs prior to cardioversion. All 13 patients on amiodarone converted to sinus rhythm with cardioversion. Prior to cardioversion the most frequently used anticoagulation was heparin in 41 patients (51%), 25 (31%) were on dicumarol, but 11 patients (14%) were not anticoagulated. One patient developed ventricular fibrillation after cardioversion, but no patient had a cerebrovascular complication. We conclude that DC cardioversion is an effective and safe method of treatment for supraventricular arrhythmias, but long term results in this study are lacking.
Gerð var afturvirk rannsókn á 80 sjúklingum (62 karlar) sem fóru í rafvendingu vegna hjartsláttartruflana frá gáttum á Landspítalanum á árunum 1986 til 1989. Sjúklingar voru á aldrinum 27 ára til 81 árs og meðalaldur hópsins var 65±10 ár. Sextíu og einn sjúklingur fór í sinustakt við rafvendingu og var frumárangur af rafvendingum því 76%. Einn sjúklingur fór í sleglatif stuttu eftir rafvendingu en aðrir fylgikvillar sáust ekki. Gáttatif var algengasta hjartsláttartruflunin, eða hjá 59 (74%) sjúklingum. Þrír undirliggjandi sjúkdómar skáru sig nokkuð úr; kransæðasjúkdómur hjá 25 (31%), háþrýstingur hjá 17 (21%) og hjartalokusjúkdómar hjá 16 (20%) sjúklingum. Sjúklingar með ósæðarlokusjúkdóm fóru hlutfallslega síður í sinustakt, en aðrir þessara sjúkdóma höfðu ekki áhrif á árangur rafvendinga. Þeir sem höfðu lungnasjúkdóm fóru hins vegar marktækt síður í sinustakt. Lyfin sem flestir voru á fyrir rafvendingu voru dígoxín 53 sjúklingar (66%) og kínidín 21 (26%) sjúklingur. Þrettán sjúklingar voru á amíódarón fyrir rafvendingu og fóru þeir allir í sinustakt. Algengasta tegund blóðþynningarlyfs fyrir rafvendingu var heparin hjá 41 (51%) sjúklingi, 25 (31%) fengu díkumaról, en 11 (14%) voru ekki á blóðþynningarlyfjum. Hjartastærð á röntgenmynd hafði ekki afgerandi áhrif á árangur rafvendingar. Í heild var frumárangur rafvendinga viðunandi og fylgikvillar fáir.
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