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长期随访期间的电再同步和临床结果室内导电延迟患者应用左捆分支节奏优化心脏再同步治疗左捆分支节奏优化心脏再同步治疗

Xueying Chen¹, Xiao Li¹, Yingnan Bai¹

¹Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases; National Clinical Research Center for Interventional Medicine, China.

Circulation. Arrhythmia and electrophysiology

|August 14, 2023

概括

与心室内导电延迟患者的双心室内CRT相比,左束枝优化心脏再同步治疗 (LOT-CRT) 提供了优异的QRS持续时间减少和心脏功能改善. 这种方法也导致24个月的不良临床结果减少.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
医疗器械医疗器械

背景情况:

左束枝优化心脏再同步治疗 (LOT-CRT) 显示出改善心脏功能和减少QRS持续时间的前景.
关于LOT-CRT在患有腹腔内导电延迟 (IVCD) 患者的疗效和可行性的数据有限.
这项研究解决了在IVCD患者中将LOT-CRT与传统的双心脏CRT (BiV-CRT) 进行比较的需要.

研究的目的:

评估和比较LOT-CRT与IVCD患者BiV-CRT的疗效和临床结果.
评估对QRS持续时间,左心室喷射率和不良临床事件的影响.

主要方法:

一项非随机研究比较LOT-CRT (n=30) 和BiV-CRT (n=55) 在连续IVCD患者中.
领先的配置策略取决于医生,以QRS复杂和临床评估为指导.
心声学参数和临床数据在基线和2年的随访期内收集.

主要成果:

无论是LOT-CRT还是BiV-CRT,都显示出高的成功率 (分别为96.8%和96.4%).
在多个随访点上,LOT-CRT实现了显著更大的QRS持续时间减少 (42.7 ms与21.9 ms相比;P<0.001) 和更高的左心室喷射率.
在24个月内,LOT-CRT组心力衰竭再住院和死亡率明显降低 (HR,0.33;P=0.035).

结论:

在IVCD患者中,LOT-CRT似乎比BiV-CRT更有效地增强心室电同步.
与BiV-CRT相比,LOT-CRT在这个患者群体中可能会导致更好的临床结果.
通过随机对照试验进行进一步验证是有必要的.

关键词:

心脏再同步治疗心脏再同步治疗心脏衰竭是因为心脏衰竭.内导电延迟是因为内导电延迟左捆的分支节奏节奏,分支节奏.长期的后续监测.

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