Improving the acceptability of the atrial defibrillator for the treatment of persistent atrial fibrillation: the atrial defibrillator sedation assessment study (ADSAS)
| Autor: | Philip A.R. Spurrell, Bart Gerritse, Andrew Mitchell, Neil Sulke |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Defibrillation medicine.medical_treatment Sedation Midazolam Premedication Conscious Sedation Cardioversion Lorazepam Risk Assessment Reference Values Internal medicine Atrial Fibrillation medicine Confidence Intervals Cyclizine Humans Single-Blind Method Aged Pain Measurement Probability Aged 80 and over Analgesics Cross-Over Studies Morphine business.industry Atrial fibrillation Dextromoramide Middle Aged Patient Acceptance of Health Care medicine.disease Crossover study Defibrillators Implantable Treatment Outcome Anesthesia Chronic Disease Cardiology Drug Therapy Combination Female medicine.symptom Cardiology and Cardiovascular Medicine Cardioversions business medicine.drug |
| Zdroj: | International journal of cardiology. 96(2) |
| ISSN: | 0167-5273 |
| Popis: | Background: To compare the acceptability and effectiveness of three pre-medication regimens for manually activated cardioversion of recurrent persistent atrial fibrillation. Methods: Eighteen patients implanted with the Jewel AF atrial defibrillator for drug-resistant persistent atrial fibrillation only were studied in an open-labelled randomised crossover study. Patients were assigned to sedation (S) with midazolam elixir, analgesia (A) with morphine sulphate or combination therapy (C) with dextromoramide and lorazepam. Pre-medication was taken up to 1 h before cardioversion. Patients rotated through each type of medication after undertaking at least one cardioversion. Visual analogue scales were completed immediately post-cardioversion and 24 h later for pain, anxiety and ‘unpleasantness'. Higher scores represented a worse outcome. Results: After 2 years' follow-up, 238 cardioversions were performed with S, 17 with A and 35 with C. The mean immediate combined score for S (10.9, 95% confidence interval (CI) 8.2–13.6) was significantly lower than for A (17.3, 95% CI 15.1–19.5, P =0.01) and for C (15.9, 95% CI 12.3–19.6, P =0.02). All patients who used S chose it as the most favourable pre-medicant. All patients who used A found it the least acceptable. Conclusion: Sedation rather than analgesia enhanced the acceptability of manually activated atrial defibrillation. |
| Databáze: | OpenAIRE |
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