[AF-FORUM] 123E 脑钠肽. Dr. Naccarella

[AF Symposium]

不知哪位专家能回答下面的问题，我将不胜感激。

脑钠肽对于预测房颤合并兴衰患者房颤复发有何意义 
（我们待发表的文章有这方面的论述）？ 在这些患 
者中那些不应该再接受电转律。

我通常对于症状很明显的患者，或者血液动力学不稳 
定的患者转律。相反，对于患者为慢性房颤，或者以 
前有过很多转律失败经历的患者我不进行转律。但是 
对于我不清楚确切房颤发生时间，而左房小于50mm的 
患者我至少会尝试至少一次转律。

另外，我发现ESC和ACC治疗指南上对心衰合并房颤的治 
疗意见不全面，也许在灯进一步的研究数据，比如加 
拿大的AF CHF试验和意大利的GISSI AF试验，尽管这些试 
验原来的目的并非针对心衰合并房颤的内容。
在这一期杂志上一些芬兰的作者已经公布了一些数 
据，上一期ESC杂志上也公布了一些EURO Heart Survey的结果

Dr FRANCO NACCARELLA MD FACC FESC FAHA
NASPE HRS INTERNATIONAL FELLOWSHIP IN BOLOGNA
意大利

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123E NT pro BNP. Dr. Naccarella

I would be grateful if the panel of experts could inform me about
the  following question:

2) utility of NT pro BNP in predicting recurrences of atrial
fibrillation in patients with AF AND CHF (as in our unpablished
experience), who should not be cardioverted any more a this time？
Fortunately we do have other clinical criteria to cardiovert these  
patients,
I use to cardiovert patients very symptomatic fort AF IN THIS CONTEX
OR AF POORLY TOLERATED FROM THE HEMODYNAMIC POINT OF VIEW
Conversely I do not cardiovert to sinus rhythm patients with chronic
AF, or multiple previous ineffectice cardioversions, but If I do not
know the period of AF occurence  and the left atrium is inferior to
50 mm I would try at least one cardioversion

Furthermore I found both ESC and ACC guidilenes of AF in CHF
incomplete, may be waiting for the complete data of the canadian AF
CHF and the italian GISSI AF, which is not dealing primarly with AF
CHF patients.
Some data have been published on this issue by Finnish authors and the
EURO Heart Survey on AF in the last number of the ESC magazine

Sincerely

Dr FRANCO NACCARELLA MD FACC FESC FAHA
NASPE HRS INTERNATIONAL FELLOWSHIP IN BOLOGNA
ITALY

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee