左束支部区域节奏导致更多的生理心室激活比双心室节奏在左束支部阻塞心力衰竭的患者
Ondrej Sussenbek1, Leonard Rademakers2, Petr Waldauf3
1Cardiocenter, Third Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Srobarova 1150/50, Praha 10, Prague 10034, Czechia.
概括
左捆支部区域节奏 (LBBAP) 和双心室节奏 (Biv) 都可以改善心脏再同步治疗 (CRT) 对心力衰竭患者的左捆支部阻塞 (LBBB). 与Biv.相比,LBBAP显示出更多的生理心室激活模式.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏再同步治疗 (CRT) 是一种心脏再同步疗法.
背景情况:
- 双胞胎节奏 (Biv) 和左捆分支区域节奏 (LBBAP) 是CRT方法.
- 在LBBAP和Biv期间心室激活模式尚不清楚.
- 左捆分支区块 (LBBB) 是CRT的一个常见标志.
研究的目的:
- 在LBBB患者中比较LBBAP和Biv之间的腹腔激活模式.
- 评估LBBAP和Biv在减少心室失调方面的疗效.
主要方法:
- 追溯分析80名CRT患者的LBBB.
- 超高频心电图 (UHF-ECG) 用于记录心室激活.
- 对LBBB,LBBAP和Biv节奏进行比较;对e-DYS和Vdmean参数进行分析.
主要成果:
- 与LBBB相比,LBBAP和Biv都显著减少了QRS持续时间.
- LBBAP导致比Biv (分别为33毫秒和59毫秒) 更短的e-DYS (24毫秒) 和Vdmean (53毫秒).
- 在LBBAP亚型或基于V6RWPT的节奏策略之间没有发现QRSd,e-DYS或Vdmean的显著差异.
结论:
- 在LBBB患者中,Biv CRT和LBBAP都有效地降低了心室失同.
- 与Biv.相比,LBBAP与更多的生理心室激活有关.
- 进一步的研究可能会阐明CRT的最佳节奏策略.
相关概念视频
01:22Heart Failure Drugs: β-Blockers
398
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
398
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
12
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
12
01:29Heart Failure II: Pathophysiology
17
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
17
01:26Heart Failure Drugs: Inotropic Agents
645
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
645
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:22Mitral Stenosis I: Introduction
19
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
19