从SmartDelay确定AV优化的初级结果:与心脏再同步治疗 (SMART-AV) 试验中使用的其他AV延迟方法进行比较:一项随机试验,比较心脏再同步治疗中的经验性,心声回声指导和算法心房延迟编程
Kenneth A Ellenbogen1, Michael R Gold, Timothy E Meyer
1Division of Cardiology, VCU School of Medicine, PO Box 980053, Richmond, VA 23298-0053, USA. kellenbogen@mcvh-vcu.edu
Circulation
|November 25, 2010
概括
使用SmartDelay或心声回声学优化心 (AV) 延迟用于心脏再同步治疗 (CRT) 没有显示出对固定120毫秒的AV延迟有任何益处. 对于CRT患者,不建议常规使用这些AV优化方法.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 心房 (AV) 延迟是影响心脏再同步治疗 (CRT) 反应的关键变量.
- 在CRT患者中,SMART-AV试验比较了固定,心声学优化和SmartDelay优化的AV延迟.
研究的目的:
- 为了比较SmartDelay和基于心声学的AV延迟优化与CRT患者固定AV延迟的疗效.
- 评估不同AV延迟编程策略对心脏功能和患者结果的影响.
主要方法:
- 将980名CRT患者的前景随机分为固定 (120毫秒),心声学优化或SmartDelay优化AV延迟组.
- 在植入后3个月和6个月评估初级终点 (左心室末缩体积) 和二级终点.
主要成果:
- 在SmartDelay,心声和固定AV延迟组之间,在6个月后左心室末缩体积的改善没有显著差异.
- 包括纽约心脏协会等级,生活质量和射出分数在内的二次终点也显示,两组之间没有显著差异.
结论:
- 智能延迟和心声回声学优化不优于CRT的固定120毫秒的AV延迟.
- 目前,评估的AV优化技术的常规使用并不合理.
- 不能排除非响应CRT患者的潜在实用性.
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