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穿皮专利孔圆形关闭后新发起的心房动:一个元分析
Dominik Jurczyk1, Sascha Macherey-Meyer2, Elias Rawish3,4
1Medical Clinic II, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany. dominik.jurczyk@uksh.de.
概括
与保守的管理相比,穿皮专利卵孔 (PFO) 关闭显著增加了新发动心房的风险. 监控策略和设备类型可能会影响AF发病率的术后情况.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 电子生理学 电子生理学
背景情况:
- 皮肤穿透孔膜 (PFO) 关闭后新发动心房动 (AF) 的发生率和预测因素尚未得到充分确立.
- 了解这些因素对于患者管理和风险分层至关重要.
研究的目的:
- 为了确定皮肤PFO关闭后手术后AF的发病率.
- 调查不同查策略和关闭装置对AF发生率的影响.
主要方法:
- 对受控试验和队列研究进行了系统的元分析.
- 在主要数据库 (Cochrane,MEDLINE,EMBASE) 中进行了搜索.
- 新发性AF发病率是主要结局,对监视,设备类型和神经事件进行了二次分析.
主要成果:
- 对受控试验的元分析显示,PFO闭包组与保守组 (1.6%) 之间的AF发病率显著更高 (5.1%).
- 较高质量的监测 (Holter-ECG,循环记录器) 与较低质量的监测 (0.2-4.3%) 相比,与更高的检测AF发病率 (3.3-15%) 相关.
- 特定设备 (CardioSEAL,Starflex) 显示出更高的早期和晚期AF发病率 (4.5%,4.2%).
结论:
- 与保守的策略相比,穿皮PFO关闭与术后AF的发病率更高.
- 监测和随访协议的变化限制了关于AF发病时间的发现的概括性.
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