左捆分支区域步调与其捆绑步调作为主要步调策略的结果:系统审查和元分析
Amr Abdin1, Christian Werner1, Haran Burri2
1Internal Medicine Clinic III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Homburg/Saar, Germany.
Pacing and clinical electrophysiology : PACE
|October 9, 2023
概括
与His bundle pacing (HBP) 相比,左束支部区域节奏 (LBBaP) 显示出优异的结果,用于新的永久起器. LBBaP证明了更高的植入成功率和降低死亡率和心力衰竭住院治疗.
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:
- 像His捆绑节奏 (HBP) 和左捆绑分支区域节奏 (LBBaP) 这样的新型节奏技术旨在保持生理心室激活.
- 这些技术越来越多地用于需要 de novo 永久节奏的患者.
研究的目的:
- 在需要新的永久心脏起器植入的患者中,比较LBBaP与HBP的结果.
- 评估这两种节奏策略的有效性和安全性.
主要方法:
- 随机临床试验和比较LBBaP和HBP的观察性研究进行了系统审查,直到2023年3月1日.
- 对包括节奏指标,QRS持续时间,领先修订,程序参数,全因死亡率和心力衰竭住院治疗 (HFH) 在内的结果进行了元分析.
主要成果:
- 分析包括10项研究,涉及1596名患者.
- LBBaP显示了更高的植入成功率 (RR 1.24) 和在植入和随访时更低的捕获值.
- 与HBP相比,LBBaP与更短的手术和光镜时间相关,并显著降低了所有原因死亡率 (RR:0.50) 和HFH (RR:0.57) 的风险.
结论:
- 左捆支部区域步调 (LBBaP) 在步调指标和植入成功方面优于His捆步调 (HBP),作为初始策略.
- 虽然有希望,但没有头对头的随机试验需要谨慎解释这些发现.
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