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在心脏节拍过程中心力衰竭

Michael O Sweeney¹, Anne S Hellkamp

¹Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. mosweeney@partners.org

|April 26, 2006

概括

右心室角节奏增加了心力衰竭住院的风险,特别是在低射出率或心力衰竭的患者中. 管理节奏模式和QRS持续时间对于降低这种风险至关重要.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
医疗器械医疗器械

背景情况:

右心室角 (RVA) 节奏可以导致异常的左心室收缩,增大和功能减弱.
室腔脱同步从RVA节奏与心力衰竭住院 (HFH) 的风险增加有关.

研究的目的:

在接受双室 (DDDR) 与心室 (VVIR) 节奏的患者中确定HFH的预测因子.
分析基线特征和节奏参数对高风险的影响.

主要方法:

模式选择试验分析了2010名患者6年,比较DDDR和VVIR节奏.
考克斯的比例危险模型被用来确定HFH的预测因素,包括纽约心脏协会 (NYHA) 的类别,心力衰竭,心 (AV) 阻塞,心肌梗塞 (MI),累积百分比心室节奏 (Cum%VP) 和QRS持续时间 (QRSd).

主要成果:

基线NYHA类,心力衰竭,AV阻塞和MI预测HFH.
植入后预测因素包括高的VVIR Cum%VP (>80%),特定的DDDR/VVIR Cum%VP值,以及节奏与自发QRS持续时间.
低射出分数 (EF) 和更长的QRSd (特别是在节奏时) 是显著的预测因素,正常EF患者的风险增加更快.

结论:

HFH风险受到患者基质 (例如,心房动,心力衰竭,EF) 和步调参数 (例如,QRSd,Cum%VP,步调模式) 之间的相互作用的影响.
有效地管理RVA节奏对于减轻HFH风险至关重要,特别是在低EF和现有心力衰竭的脆弱患者群体中.

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