病気のシナス症候群の患者の長期追跡中の心房内経伝導
H R Andersen1, J C Nielsen, P E Thomsen
1Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark.
Circulation
|September 30, 1998
まとめ
心房ペースを施す病気シナス症候群の患者は,長期的に安定したAV伝導を示します. このペースメソッドは,バンドル・ブランチ・ブロックのない人にとって安全であり,AVブロックの発生率は低い.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 医療機器 医療機器について
背景:
- シヌス病症候群 (Sick Sinus Syndrome,SSS) は,心臓の自然なペースメーカーに影響する疾患である.
- 以前の主張は,SSSの患者が心房静脈 (AV) ブロックのリスクが高いことを示唆しています.
- SSS患者におけるAV伝導の見通し評価は欠けていた.
研究 の 目的:
- 病気シナス症候群 (SSS) の患者における心房静脈伝導 (AV) を前向きに評価する.
- SSSにおける単室性心房ペースの安全性と有効性を,心房ペースと比較して評価する.
- 長期的なAV伝導の安定性とAVブロックの発生率を決定するために.
主な方法:
- 将来のランダム化試験は,無傷なAV伝導を持つSSS患者225人を対象に実施されました.
- 患者はランダムに単一室の心房ペース (110) または心室ペース (115) に割り当てられました.
- 長期フォローアップ (平均5.5年) には,PQ間隔,心房刺激-Q間隔,およびウェンケバッハブロックポイント測定が含まれていました.
主要な成果:
- PQ間隔や心房刺激-Q間隔の有意な変化は,いずれのグループでも観察されなかった.
- ウェンケバッハのブロックポイントは,心房ペースグループでは安定したままでした.
- 胸前ペースメーカー群の4人の患者 (3.6%) が,2~3度のAVブロックを発症し,ペースメーカーのアップグレードが必要となった (年間0.6%).
結論:
- SSS患者における長期追跡期間中,心房静脈伝導は安定しています.
- シングル・チャンバ・アトリアル・パッシングは,バンドル・ブランチ・ブロックのないSSS患者にとって安全な治療法です.
- SSS患者には,心房ペースを推奨し,AVブロックを注意深くモニタリングすることができます.
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