长期表现的表皮心与跨静脉左心室导致心脏再同步治疗治疗
Gijs E de Maat1, Bart A Mulder2, Martijn E Van de Lande2
1Department of Cardio-Thoracic Surgery, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Journal of clinical medicine
|September 28, 2023
概括
通过VATS放置的副心左心室导线显示出与心脏再同步治疗的透静导线相比,在长期内表现优越,失败率明显较低.
科学领域:
- 心脏病学 心脏病学
- 胸部外科手术 胸部外科手术
- 生物医学工程 生物医学工程
背景情况:
- 心脏再同步治疗 (CRT) 依赖于有效的左心室 (LV) 置.
- 通过静脉输入的安置是标准的,但在某些患者中可能具有挑战性或不成功.
- 心LV线索提供了一个替代方案,特别是当通过静脉的方式失败时.
研究的目的:
- 通过视频辅助胸部外科手术 (VATS) 放置的表心LV导线与通过静脉放置的CRT导线的技术性能和长期结果进行比较.
- 为了评估两个放置方法之间的故障率和能源消耗.
主要方法:
- 在2001年至2013年期间,对644个CRT的置流程进行了回顾性研究.
- 分析了两个组:578名透静脉LV导入患者和66名心上LV导入患者 (在经过失败的透静脉尝试后放置).
- 主要终点:需要更换或关闭的LV-lead故障. 二级终点:能源消耗.
主要成果:
- 平均随访时间为5.9年.
- 与静脉输入线索 (11%,p=0.037) 相比,心线索的失效率明显较低 (3%).
- 两组之间的能消耗没有显著差异.
结论:
- 通过VATS进行心LV位是CRT的可行,安全和有效的策略.
- 它提供了优异的长期性能和较低的故障率,与输血相比.
- 当通过静脉安置失败或在复杂的情况下考虑表心线索.
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