稳定心房动:一个范式而不是隔膜转移?
Connor L Bracy1,2, Pei-Ying Kobres2,3, Michael J Hockstein3
1From the Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia.
概括
带有左心室辅助器件 (LVAD) 的患者可能会经历清醒心室动 (VF) 或心室低心率 (VT). 这些患者往往能短期忍受心律失常,但它可能表明医院内死亡风险增加.
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:
- 醒着心室动 (VF) 和心室低心率 (VT) 是罕见的,主要发生在有机械循环支持的患者中.
- 左心室辅助器件 (LVAD) 对于末期心力衰竭管理至关重要.
研究的目的:
- 描述LVAD患者的特征和结果,他们以清醒的VF/VT向急诊室 (ED) 呈现.
- 评估与此患者队列相关的管理策略和住院死亡率.
主要方法:
- 在大批量LVAD中心对175名患者的回顾性审查.
- 在2015年12月至2021年7月期间,对19名患者进行分析,这些患者在2015年12月至2021年7月期间以清醒的VF/VT呈现给ED.
- 检查ED和住院管理,包括血液动力学参数,药物和程序.
主要成果:
- 19名LVAD患者呈现了清醒的VF/VT,保持了70mmHg的中位数MAP.
- 治疗ED通常涉及心脏转移 (58%一次,21%多次),阿米奥达龙 (68%) 和利多卡因 (21%).
- 住院护理包括除 (37%),除 (11%),抗失常药 (84%);26%的人死亡,其中1人死于复发性静脉动脉.
结论:
- LVAD患者可能会表现出持续的心室心律失常的短期耐受性.
- 在LVAD患者中醒着的VF/VT呈现可能是增加住院死亡率的预兆.
- 临床团队必须对这种表现及其对患者结果的影响保持警.
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