与左束支部区域节奏相比,双节律节奏的失律风险:I-CLAS研究的结果
Bengt Herweg1, Parikshit S Sharma2, Óscar Cano3
1University of South Florida Morsani College of Medicine, Tampa (B.H., R.B., M.M.).
Circulation
|November 11, 2023
概括
与双心室刺激相比,左束支部区域刺激 (LBBAP) 显著降低了心室失常和新的心房动. 对于心脏再同步治疗患者来说,LBBAP是一种潜在的更安全的替代方案.
科学领域:
- 心脏病学
- 电生理学
- 医疗器械
背景情况:
- 心脏再同步治疗 (CRT) 的目的是改善心脏功能.
- 左心室喷射分数 (LVEF) ≤35% 是常见的CRT指标.
- 左束枝区域节奏 (LBBAP) 是双心脏节奏 (BVP) 的替代节奏策略.
研究的目的:
- 在LBBAP和BVP之间比较持续性心房动脉/心房 (VT/VF) 和新发性心房 (AF) 的发生率.
- 在接受CRT的患者中评估LBBAP与BVP的安全性和有效性.
主要方法:
- 这项I-CLAS研究包括2018年至2022年期间接受CRT (BVP或LBBAP) 的1778名患者.
- 对1414名患者进行了倾向性比分匹配分析 (1:1比).
- 使用Cox比例危险生存模型评估了VT/ VF和新发性AF的发生率.
主要成果:
- 与BVP相比,LBBAP显示了明显较低的VT/ VF (4.2%与9.3%) 和VT风暴 (0.8%与2.5%) 的比率.
- 与BVP相比,LBBAP的新发性AF也显著降低 (2. 8% 与 6. 6% 相比).
- 在调整了基线特征后,这些发现仍然具有意义.
结论:
- 与BVP相比,LBBAP与静脉瘤/静脉瘤和新发 AF 的发病率较低.
- 通过LBBAP实现的生理再同步可能有助于减少心律失常的风险.
- 对于CRT来说,LBBAP是一个有前途的替代步调策略.
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