混合性心房移除:从单一中心的10年经验中长期的结果
Luigi Pannone1, Sahar Mouram1, Domenico Giovanni Della Rocca1
1Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Laarbeeklaan 101, 1090 Brussels, Belgium.
概括
混合动力心房动 (AF) 除为非心房动提供了一个有前途的治疗方法. 长期结果显示,五年后47.5%的心房动脉节律不变,初始和重复手术之间没有差异.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电力生理学 电力生理学
背景情况:
- 非阴性心房动 (AF) 是一个重大的临床挑战.
- 混合AF切除结合了手术和导管技术,以改善结果.
- 在大量患者队列中评估长期疗效至关重要.
研究的目的:
- 评估混合AF切除的长期成功率.
- 为了比较初始和重复混合式消融程序之间的结果.
- 为了确定心房动脉节律衰退复发的预测因子,在混合切除后.
主要方法:
- 从2010年到2020年,对120名连续接受混合AF切除术的患者进行了回顾性分析.
- 混合切除涉及一个单步胸腔镜和内心脏的方法.
- 主要终点是在62.3个月的平均随访期间没有心房动脉节律失常 (ATas).
主要成果:
- 在大约5年的平均随访后,52.5%的患者经历了ATas复发.
- 在第一次和重复手术之间没有观察到ATas复发的显著差异 (P=0.53).
- 左心房体积指数和空白期的复发预测了ATas的复发.
结论:
- 混合AF切除可以在非发热性AF中提供中等长期的ATas释放.
- 这种程序既有效作为初始治疗,也有效作为重复治疗.
- 进一步研究预测复发是有必要的.
相关概念视频
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...