心脏再同步治疗后心室节律失常的影响
Nobuhiko Ueda1, Kohei Ishibashi1, Takashi Noda1
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Heart rhythm
|September 22, 2023
概括
在心脏再同步治疗 (CRT) 患者中,心室心律不整 (VA) 表明死亡或心力衰竭住院的风险更高. VA与电阻延迟和CRT响应减少有关,这表明预后不佳.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
背景情况:
- 关于与心室心律失常 (VA) 和休克治疗相关的死亡风险存在相互矛盾的数据.
- 心脏再同步治疗 (CRT) 可以降低VA风险,但其在CRT患者的预后意义尚不清楚.
研究的目的:
- 在接受心脏再同步治疗 (CRT) 的患者中,确定心室心律失常 (VA) 的预后值.
主要方法:
- 在CRT植入后的一年内,对330名患者进行了随访.
- 主要终点是所有原因死亡率或心力衰竭住院治疗的复合结果.
主要成果:
- 在43名患者中发生了心室节律失常 (VA) 事件,这些患者的初级终点风险明显更高,即使在CRT反应者中 (P = .009).
- 快速VA与增加的初级终点风险相关 (HR 2.14;P = .035),而休克治疗没有 (P = .269).
- 患有VA的患者CRT反应率较低 (53%对70%;P = .031) 和较长的左心室节奏导电时间 (174 ms对143 ms;P = .003).
结论:
- 在CRT后一年内发生心室失常 (VA) 与节奏电阻延迟和CRT响应减弱有关.
- 在心脏再同步治疗患者中,VA可能是预后不佳的指标.
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