在心脏手术和跨导管结构干预后,无心脏起器植入的结果
Jingwen Huang1, Neal K Bhatia1,2, Michael S Lloyd1,2
1Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Journal of cardiovascular electrophysiology
|September 20, 2023
概括
无心脏起器在心脏手术和门干预后表现出色,但有些患者可能需要转换到输血系统以支持节奏. 对这些患者来说,密切的电生理学随访是必不可少的.
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:
- 在心脏手术和透导管结构干预后,经常需要永久的节奏控制.
- 无心脏起器 (LPs) 为输血系统提供了替代方案,但它们在这种特定患者群体中的结果尚未得到充分确立.
- 目前的LP缺乏心房节奏和心脏重同步能力.
研究的目的:
- 评估无心脏起器 (Micra VR和Micra AV) 在接受心脏手术或透气管结构干预的患者的安全性和有效性.
- 评估设备性能,临床结果,以及转换到跨静脉节奏系统的必要性.
主要方法:
- 一项对78名患者进行的回顾性研究,这些患者在心脏手术或透管结构干预后接受了Micra VR或Micra AV无心脏起器.
- 在平均1.3年的随访期间,对设备的电性能,心室节奏负担,左心室喷射率 (LVEF) 和转换率到静脉穿透节奏的评估.
主要成果:
- 观察到设备的电气性能很好,步调值和阻抗的变化最小.
- 随着时间的推移,右心室的平均节奏负担显著下降 (74.3%至47.7%,p < .001).
- 总体来看,LVEF的温和但显著下降趋势 (55.0%至51.5%,p < .001),在Micra VR组的下降更为明显.
- 7.7%的患者需要转换为心脏再同步或心房节奏支持的输静脉节奏.
结论:
- 无心脏起器是心脏手术和透导管干预后需要节奏的患者的可行选择,在中期表现出色.
- 显著的比例的患者可能需要转换到通过静脉输血系统的高级节奏需求,突出警的电生理学监测的重要性.
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