无声肺静脉在心房的重复切除过程中:影响和方法
Peter Calvert1,2, Wern Yew Ding1,2, Michael Griffin2
1Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
概括
患有无声肺静脉 (PVs) 进行重复心房移除的患者面临更糟糕的结果. 在重复除时的静音PVs表明不良事件和心律失常复发的风险更高,影响长期预后.
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:
- 肺静脉隔离 (PVI) 是对心房动 (AF) 的主要治疗方法.
- 在AF管理中,有时需要重新除手术.
- 在重复手术中,肺静脉 (PVs) 可以被隔离 (静音) 或重新连接.
研究的目的:
- 根据PV状态 (沉默与重新连接) 调查接受重复AF切除术的患者的临床结果.
- 为了确定与需要重复AF切除的患者的不良结果相关的因素.
主要方法:
- 分析了一组467名在2013年至2019年期间接受重复AF切除术的患者.
- 患者被分为静音PV或重新连接PV的组.
- 主要结局:由进一步的重复切除,非AF切除,心房结节切除或死亡组成. 二次结局:心律失常的复发.
主要成果:
- 10.3%的患者在重复切除时有无声的PVs.
- 沉默的PV组显示出更高的初级结局率 (25%对13.8%) 和显著更多的心律失常复发率 (66.7%对50.6%) 的趋势.
- 主要结局的独立预测因素包括女性性别和缺血性心脏病;对于复发,左心房扩大和先前的切除是显著的.
结论:
- 在重复AF切除过程中静音PVs的患者经历了较差的临床结果.
- 在重置除时的静音PVs作为临床医生的预后指标.
- 识别沉默的PV可以帮助预测和管理潜在的不良事件和复发.
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