Nėščių moterų prieširdžių virpėjimo valdymas: flekainido ir ibutilido vartojimo farmakologinei rimto kontrolei palyginimo apžvalga
Brand, Christian Gerhard Julius |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Management of atrial fibrillation in pregnant women: a systematic literature review on the use of flecainide compared to ibutilide as pharmacological rhythm control Research aim and objectives: Aim: To evaluate the reasons of use and prove evidently the superiority of either flecainide or ibutilide for the acute pharmacological treatment of atrial fibrillation in pregnant women. Objectives: 1. To extract and analyse current scientific data on the efficacy of flecainide and ibutilide in the treatment of atrial fibrillation in pregnant women 2. To extract and analyse current scientific data on the safety of flecainide and ibutilide for pregnant women and their foetuses 3. To conclude and summarise the best pharmacological strategy for the rhythm control of acute atrial fibrillation in pregnant women. Methodology: Articles were identified by a search from “PubMedCentral” and “ScienceDirectSpringer” on the 24th of July 2021 and 19th of August 2021 respectively. Search terms with the following combination were used: “(flecainide OR ibutilide) AND (pregnancy)”. Further only free access articles and works in English and German language were used during this work. Anticipating the most likely low number of clinical trials of this vulnerable patient group and the possible benefit of long-time experience with the drugs, the databases were not restricted in terms of publishing dates. Abstract and full text screening were used to exclude unrelated works in accordance with the PICO process, namely: P (pregnant women with atrial fibrillation), I (use of ibutilide), C (use of flecainide), O (efficacy in Afib management, safety for fetus and mother). Results: During the research 10 reviews and 2 guidelines mentioning the use of either flecainide or ibutilide in the context of pregnant women with atrial fibrillation could be extracted. Conclusion: The data on flecainide as well as ibutilide is very limited regarding efficacy and safety for the management of atrial fibrillation in pregnant women. More research has to be done for that specific patient group. Either flecainide or ibutilide should only be used in pregnant women without structural heart diseases and which have received a cardiological check-up before drug administration.
Šiame tyrime sistemingai apžvelgiama flekainido ir ibutilido, kaip galimos nėščių moterų prieširdžių virpėjimo farmakologinės kardioversijos, vartojimo rizika ir nauda. 10 tinkamų apžvalgų ir 2 gairės randamos „PubMedCentral“ ir „ScienceDirectSpringer“. Kadangi atlikta nedaug tyrimų, negalima padaryti įrodymais pagrįstos galutinės išvados apie vieno iš vaistų pranašumą ir reikia papildomų tyrimų. Abu vaistai yra vertingas būdas gydyti struktūrinių širdies ligų neturinčias moteris.