在TAVR后的导电异常导致永久心脏起器植入:风险因素,预防和管理
Rachad Ghazal1, Haroutioun Garabedian1, Fadi Sawaya2,3
1Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Journal of cardiovascular electrophysiology
|January 23, 2024
概括
透气管大动脉置换 (TAVR) 增加了对心脏起器的需求. 预先存在的导电问题,男性性别,年龄较大以及特定的TAVR程序是关键风险,需要个性化预防和进一步的管理研究.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 电子生理学 电子生理学
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见手术.
- TAVR可以导致显著的导电异常,通常需要永久心脏起器 (PPM) 植入.
研究的目的:
- 审查TAVR后对PPM风险因素的现有元分析.
- 确定关键预测因素,并讨论TAVR相关传导干扰的预防和管理策略.
主要方法:
- 系统审查和综合38个元分析的数据.
- 对患者人口统计学,先前存在的疾病和与PPM植入后TAVR相关的程序特征的分析.
主要成果:
- 以前存在的右束分支阻塞 (RBBB),左前束阻塞 (LAHB) 和新出现的左束分支阻塞是PPM的重要风险因素.
- 男性患者,老年人,输接入和自扩展门与PPM的风险更高有关.
- 基于电生理学和解剖学资料的个性化TAVR方法可以帮助预防.
结论:
- 在TAVR后的导电异常是一个重大问题,具有可识别的风险因素.
- 目前的证据表明,个性化的TAVR策略可以减轻风险.
- 对标准化管理协议和对TAVR后传导干扰的进一步研究非常需要.
更多相关视频
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
14.7K
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
3.5K
相关概念视频
Decreased pulse rate
544
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
544
Disturbances in Heart Rhythm
961
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...
961
Mechanism of Cardiac Arrhythmias
922
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
922
Increased pulse rate
667
Tachycardia is a condition marked by an abnormally fast or irregular heart rate, surpassing the typical resting rate. In adults, tachycardia is characterized by a pulse rate ranging from 100 to 180 beats per minute. The increased heart rate can result in inadequate blood flow to various body parts, ultimately diminishing the oxygen supply to organs and tissues.
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
667
