在鼻节功能障碍和发生性心房的风险中最大限度地减少心房节奏:一个随机试验
Mads Brix Kronborg1,2, Maria Hee Jung Park Frausing1,2, Jerzy Malczynski3
1Department of Cardiology, Aarhus University Hospital, Palle-Juul Jensens Bvld. 99, 8200 Aarhus, Denmark.
European heart journal
|August 28, 2023
概括
在鼻节功能障碍患者中最大限度地减少心房节奏并没有减少心房动. 将基速降低到每分钟40拍,而没有适应速度的节奏,会增加昏风险.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 高心房节奏百分比与心房动风险增加有关.
- 节功能障碍 (SND) 影响心律调节.
- 心脏起器植入是SND管理中常见的.
研究的目的:
- 为了确定最小化心房节奏是否会降低SND患者心房的发生率.
- 为了比较DDDR-60和DDD-40节奏模式之间的结果.
主要方法:
- 全国随机对照试验,540名SND患者.
- 比较DDDR-60 (基速60bpm,速度适应) 与DDD-40 (基速40bpm,没有速度适应).
- 长达两年的随访与远程监测;主要终点:第一个心房发作的时间>6分钟.
主要成果:
- 中位心房节奏:1% (DDD-40) 和49% (DDDR-60).
- 两组之间心房发病率没有显著差异 (两组均为46%).
- 在DDD-40组中,昏迷/昏迷前的发病率较高 (HR 1.71,P = .01).
结论:
- 在SND中,心房节奏减小并没有降低心房动.
- DDD-40节奏 (40bpm,没有速度适应性) 增加了昏迷/昏迷前风险.
- 节奏策略需要仔细考虑有效性和安全性终点.
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