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跨导管大动脉替换后的心室节奏依赖:一个潜在的队列
Sirin Apiyasawat1,2, Mann Chandavimol1, Natcha Soontornmanokati1
1Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Cardiovascular diagnosis and therapy
|September 7, 2023
概括
通过导管的大动脉置换 (TAVR) 后的新心室节奏依赖 (VpDep) 在7.9%的患者中发生. 预先存在的导电问题,如右捆分支块增加VpDep风险,但不会影响死亡率.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 过导管大动脉置换 (TAVR) 与心房导电障碍有关.
- 并非所有TAVR后的导电问题都会导致心室节拍依赖 (VpDep).
研究的目的:
- 为了确定TAVR后新的VpDep的发病率,预测因素和结果.
- 分析VpDep和TAVR后所有原因死亡率之间的关联.
主要方法:
- 对127例输性TAVR病例 (2015-2020年) 的前性分析.
- 排除了先前有VpDep的患者;排除了3名先前有节奏依赖CIED的患者.
- 针对VpDep和死亡率预测因子的多变量后勤和考克斯回归分析.
主要成果:
- 一个月后,VpDep发生率为7.9%,在患有心脏植入式电子设备 (CIED) 的患者中更高 (34.5%).
- 以前存在的右束支部阻塞 (OR 21.38) 和严重的第一级或莫比茨I心房阻塞 (OR 14.79) 是VpDep的显著预测因素.
- 在平均随访25.8个月后,没有发现VpDep和全因死亡率之间的显著关联.
结论:
- 预先存在的导电异常是VpDep后TAVR的显著预测因素.
- 在这个队列中,TAVR后的VpDep并没有导致死亡率增加.
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