尽管进行了索引导管切除,但预测从发性到持续性心房动的进展的因素
Guan-Yi Li1,2, Ahmed Moustafa Elimam1,3, Li-Wei Lo1,2
1Department of Medicine, Heart Rhythm Center, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Journal of cardiovascular electrophysiology
|October 12, 2023
概括
经过切除后,从阳性心房 (PAF) 到持续性心房 (PersAF) 的进展与较大的左心房直径,非肺静脉触发物和甲状腺疾病有关. 这些因素预测了 AF 经消去后的进展.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学研究 医学研究
背景情况:
- 尽管进行了导管切除,但一些患者从阳性心房动 (PAF) 进展到持续性心房动 (PersAF).
- 这种进展的基本机制仍然不清楚.
研究的目的:
- 在患有偏激性AF (PAF) 的患者中,在导管切除后,研究进展到持久性AF (PersAF) 的预测因素.
主要方法:
- 分析了400名PAF患者的队列,这些患者接受了索引切除.
- 患者根据结果进行分类:鼻节律,复发的PAF或进展到PersAF.
- 收集了基线和程序数据,以评估AF复发和进展的预测因素.
主要成果:
- 3年后,7%的患者从PAF转变为PersAF. 在消去后,7%的患者从PAF转变为PersAF.
- 更大的左心房 (LA) 直径和非肺静脉 (PV) 触发预测的复发.
- 较大的LA直径,非PV触发器,以及甲状腺疾病史预测进展到PersAF.
结论:
- 从PAF到PersAF的进展与更大的LA直径,甲状腺疾病史和非PV触发因素有关.
- 建议包括细致的手术前评估,患者选择,以及在切除过程中进行全面的挑测试.
相关概念视频
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
22
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
22
Disturbances in Heart Rhythm
981
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
981
Dysrhythmias V: Evaluating Dysrhythmias
41
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
41
Dysrhythmias III: Characteristics of Dysrhythmias
12
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
12
Dysrhythmias IV: Characteristics of Bradyarrhythmias
10
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
10
Dysrhythmias VI: Management of Dysrhythmias
19
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
19


