在一个未经选择的全国性队列中,左心室植入失败
Daniel J Friedman1, Li Qin2, James V Freeman2
1Electrophysiology Section, Duke University Hospital, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Heart rhythm
|July 5, 2023
概括
在心脏再同步治疗中,左心室头植入物失败并不常见,冠状动脉鼻接入问题是主要原因. 年龄较小,女性性别,少数种族/少数民族以及缺乏专业培训是关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电子生理学 电子生理学
背景情况:
- 左心室 (LV) 植入是心脏再同步治疗 (CRT) 中的一个关键和具有挑战性的步骤.
- 早期的研究表明,LV植入物失效率显著,约为10%.
研究的目的:
- 确定LV植入物失败的发生率,原因和独立预测因素.
- 分析与成功的CRT领先配置相关的因素.
主要方法:
- 分析了2010-2016年期间接受计划CRT的111,000多名患者,使用了国家心血管数据注册表ICD注册表.
- 使用后勤回归来确定LV植入物失败的独立预测因素.
主要成果:
- 在3.6%的患者中发生了LV植入器失败,冠状动脉鼻接入失败是最常见的原因 (64.3%).
- 独立预测因素包括年轻的年龄,女性性别,黑人种族,西班牙裔种族,更长的QRS持续时间,阻塞性睡眠呼吸暂停和非电生理学训练的植入者.
结论:
- 现在LV植入器的失败不常见,主要是由于冠状动脉鼻接入的挑战.
- 识别患者和程序因素可以帮助优化CRT植入成功率.
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