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心筋梗塞後の抵抗性心房動嵐のカテーテル除去
Yuki Komatsu1, Mélèze Hocini2,3,4, Akihiko Nogami1
1Department of Cardiology, Faculty of Medicine, University of Tsukuba, Japan (Y.K., A.N., K.A., M.I.).
Circulation
|April 2, 2019
まとめ
カテーテル除去は,心筋梗塞 (MI) の後の心室細動 (VF) 嵐を効果的に治療し,再発を減少させます. しかし,長期的な生存は,根本的な心臓病の重症度および併発性疾患に依存します.
科学分野:
- 心臓病科
- 電気生理学
- 介入心臓科
背景:
- 心筋梗塞 (MI) の後の心房細動 (VF) は,複数の除細動を必要とする重大な状態です.
- カテーテル切除は 治療に抵抗する 静脈炎の治療法です
- 大規模な患者集団におけるカテーテル切除の生存への影響は未確認のままである.
研究 の 目的:
- MI後の耐火性VFストームの治療におけるカテーテルアブレーションの有効性を評価する.
- 病院内および長期の死亡率に対するカテーテル切除の影響を評価する.
- MI後のVFの嵐のためにアブレーションを受けた患者の死亡率に関連した要因を特定する.
主な方法:
- 110人の患者で実施された多中心的,遡及的観察研究では,心筋梗塞後の耐久性静脈炎の暴風雨が発生した.
- プルキニエに関連した静脈炎を誘発する 静脈炎を標的とした消去.
- 病院内および長期の死亡率は,ロジスティック回帰およびコックス比例リスクモデルを使用して分析された主要な結果でした.
主要な成果:
- 静脈炎の嵐は84パーセントの患者で減少し,入院死亡率は27パーセントでした.
- 病院での死亡率は,VFの発症と消去の間の遅延 (OR1. 11/ 日) と関連していた.
- 長期死亡率 (36%) はエジェクション分数減少 (< 30%),NYHAクラス≥III,心房動,慢性腎臓疾患と関連していました.
結論:
- 焦点トリガーのカテーテル切除は,VF嵐のMI後の命を救うもので,再発から短期的かつ長期的に自由です.
- 長期的死亡率は,基礎となる心血管疾患および併発症の重度によって著しく影響を受けます.
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