Background: Electrical cardioversion in patients with atrial fi- brillation(AF) is associated with an increased risk of stroke. We compared a transesophageal echocardiography(TEE)- guided strategy with a conventional ...Background: Electrical cardioversion in patients with atrial fi- brillation(AF) is associated with an increased risk of stroke. We compared a transesophageal echocardiography(TEE)- guided strategy with a conventional strategy in patients with AF >2 days’ duration undergoing electrical cardioversion over a 6- month follow- up. Methods: The ACUTE study was a multicenter, randomized, clinical trial, with 1222 patients. Six- month follow- up was available in 1034 patients(85% ), 525 in the TEE group and 509 in the conventional group. The primary composite end points were cerebrovascular accident, transient ischemic attack, and peripheral embolism at 6 months, which was a prespecified time point. Secondary end points were hemorrhage, mortality, and sinus rhythm. Results: At 6 months, there was no difference in composite embolic events between the TEE group and the conventional group(10 [2% ] vs 4 [0.8% ]; risk ratio(RR) 2.47, 95% CI 0.78- 7.88; P=.11). However, the hemorrhagic rate was significantly lower in the TEE group(23 [4.4% ] vs 38 [7.5% ]; RR 0.58, 96% CI 0.35- 0.97; P=.04). There was no difference between the 2 treatment groups in all- cause mortality(21 [4% ] vs 14 [2.8% ]; RR 1.48, 95% CI 0.76- 2.92; P=.25) and in the occurrence of normal sinus rhythm between the 2 groups(305 [62.2% ] vs 280 [58.1% ]; P=.51). Sinus rhythm at 6 months was more common in the TEE- guided group, in those patients who had direct current cardioversion(238 [62.5% ] vs 151 [53.9% ]; P=.03). Conclusion: The TEE- guided strategy may be considered a clinically effective alternative to a conventional anticoagulation strategy for patients with AF of >2 days’ duration undergoing electrical cardioversion over a 6- month period.展开更多
目的探讨两类功能性便秘(FC)行生物反馈治疗的效果及随访结果。方法 63例FC患者为研究对象,其中STC(慢传输型便秘)33例,为A组,OOC(出口梗阻型便秘)30例,为B组,均接受生物反馈治疗,比较两组治疗前后肛管静息压、肛管最大收缩压,同时随访...目的探讨两类功能性便秘(FC)行生物反馈治疗的效果及随访结果。方法 63例FC患者为研究对象,其中STC(慢传输型便秘)33例,为A组,OOC(出口梗阻型便秘)30例,为B组,均接受生物反馈治疗,比较两组治疗前后肛管静息压、肛管最大收缩压,同时随访6个月比较两组疗效。结果两组治疗后肛管最大收缩压[(108.34±21.30)mm Hg VS(146.75±24.50)mm Hg(1 mm Hg=0.133 k Pa)]比较差异有统计学意义(P<0.05)。另外随访6个月,A组总有效率78.79%,与B组的86.67%比较差异无统计学意义(P>0.05)。结论生物反馈治疗对OOC的疗效相比STC更佳。展开更多
文摘Background: Electrical cardioversion in patients with atrial fi- brillation(AF) is associated with an increased risk of stroke. We compared a transesophageal echocardiography(TEE)- guided strategy with a conventional strategy in patients with AF >2 days’ duration undergoing electrical cardioversion over a 6- month follow- up. Methods: The ACUTE study was a multicenter, randomized, clinical trial, with 1222 patients. Six- month follow- up was available in 1034 patients(85% ), 525 in the TEE group and 509 in the conventional group. The primary composite end points were cerebrovascular accident, transient ischemic attack, and peripheral embolism at 6 months, which was a prespecified time point. Secondary end points were hemorrhage, mortality, and sinus rhythm. Results: At 6 months, there was no difference in composite embolic events between the TEE group and the conventional group(10 [2% ] vs 4 [0.8% ]; risk ratio(RR) 2.47, 95% CI 0.78- 7.88; P=.11). However, the hemorrhagic rate was significantly lower in the TEE group(23 [4.4% ] vs 38 [7.5% ]; RR 0.58, 96% CI 0.35- 0.97; P=.04). There was no difference between the 2 treatment groups in all- cause mortality(21 [4% ] vs 14 [2.8% ]; RR 1.48, 95% CI 0.76- 2.92; P=.25) and in the occurrence of normal sinus rhythm between the 2 groups(305 [62.2% ] vs 280 [58.1% ]; P=.51). Sinus rhythm at 6 months was more common in the TEE- guided group, in those patients who had direct current cardioversion(238 [62.5% ] vs 151 [53.9% ]; P=.03). Conclusion: The TEE- guided strategy may be considered a clinically effective alternative to a conventional anticoagulation strategy for patients with AF of >2 days’ duration undergoing electrical cardioversion over a 6- month period.
文摘目的探讨两类功能性便秘(FC)行生物反馈治疗的效果及随访结果。方法 63例FC患者为研究对象,其中STC(慢传输型便秘)33例,为A组,OOC(出口梗阻型便秘)30例,为B组,均接受生物反馈治疗,比较两组治疗前后肛管静息压、肛管最大收缩压,同时随访6个月比较两组疗效。结果两组治疗后肛管最大收缩压[(108.34±21.30)mm Hg VS(146.75±24.50)mm Hg(1 mm Hg=0.133 k Pa)]比较差异有统计学意义(P<0.05)。另外随访6个月,A组总有效率78.79%,与B组的86.67%比较差异无统计学意义(P>0.05)。结论生物反馈治疗对OOC的疗效相比STC更佳。
