ペースメーカー依存症とペースモードが心血管疾患に与える影響の関係
A S Tang1, R S Roberts, C Kerr
1University of Ottawa Heart Institute, Ottawa, Ontario. atang@ottawaheart.ca
Circulation
|June 27, 2001
まとめ
生理学的ペースは,ペースメーカーに依存する低ペース心拍数 (UHR) の患者に有益であり,心血管疾患による死亡と全死亡率を減少させます. ペースメーカーに依存しない患者は,同様の利点を経験しないかもしれません.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
背景:
- The Canadian Trial of Physiological Pacing (CTOPP) は,生理学的ペースが心房細動を減少させたが,死亡率,脳卒中,心不全の入院を減少させたわけではないことを明らかにした.
- 多くのペースメーカーの患者はペースメーカーの依存性がなく,十分なペースを伴わない心拍数 (UHR) を有しています.
研究 の 目的:
- ペースメーカーに依存する患者がペースメーカーに依存しない患者と比較して生理的なペースからより大きな利益を得るかどうかを調査する.
主な方法:
- ペースメーカー依存性テストを受けたCTOPP試験の2244人の患者の分析.
- 最初のフォローアップ (<60bpm vs. >60bpm) での非ペース心拍数 (UHR) に基づいたサブグループ分析.
主要な成果:
- UHRの低下は,心室ペースグループでは心血管疾患による死亡/脳卒中の増加と相関していたが,生理ペースグループではそうではなかった.
- 生理学的ペースの有意な利点は,UHR ≤60 bpmの患者で,特に心血管疾患による死亡と総死亡率で観察されました.
結論:
- 最初のフォローアップ時のペース外心拍数 (UHR) は,ペースモードの選択が死亡率に与える恩恵に影響します.
- 低UHRのペースメーカーに依存する患者は,頻繁なペースの必要性のために生理学的ペースから恩恵を受ける可能性が高い.
- ペースメーカーに依存しない患者で,ペースをめったに走らせない患者は,生理的なペースから大きな利益を得られないかもしれません.
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