有效的心脏再同步治疗对临床反应节奏的重要性:基于有效的心脏再同步治疗算法的分析
Satoshi Oka1, Nobuhiko Ueda2, Kohei Ishibashi2
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Heart rhythm
|June 12, 2023
概括
高百分比有效的心脏再同步治疗 (CRT) 节奏与更好的患者结果有关. 达到高%e-CRT显著减少心力衰竭住院,并增加成功CRT反应的可能性.
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:
- 心脏再同步治疗 (CRT) 的有效性通过高百分比的心室节奏来最大化.
- 一个有效的CRT算法使用电图形态学识别有效的左心室 (LV) 节奏.
- 百分比有效的CRT节奏 (%e-CRT) 和患者反应之间的关系仍然不清楚.
研究的目的:
- 为了澄清%e-CRT与CRT患者的临床结果之间的关联.
- 为了确定%e-CRT是否预测心力衰竭住院治疗和CRT反应.
主要方法:
- 通过使用适应性和有效的CRT算法,评估了49名CRT患者的>90%心室节奏.
- 主要结局被定义为心力衰竭 (HF) 住院,次要结局是CRT响应者患病率.
- 根据中位数的%e-CRT,将患者分为有效 (%e-CRT ≥97.4%) 和不太有效的组.
主要成果:
- 有效组显示HF住院的风险明显较低 (日志等级,P = .016).
- %e-CRT ≥97.4%预测了较低的HF住院风险 (HR 0.12; P = .045).
- 有效组具有更高的CRT响应者患病率 (92%对38%;P<.001),%e-CRT≥97.4%预测响应 (OR19.20;P<.001).
结论:
- 高%e-CRT与CRT响应者患病率的增加有关.
- 高%e-CRT与心力衰竭住院的风险降低有关.
- 优化%e-CRT可能会改善CRT患者的临床结果.
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