伴随或不伴随肺静脉隔离的左心房尾关闭的长期结果:基于CLACBAC研究的倾向性得分匹配分析
Xiang Li1,2,3, Shiyu Feng1, Zhongyuan Ren1,2
1Tongji University School of Medicine, Shanghai, 200092, China.
BMC cardiovascular disorders
|February 3, 2024
概括
与肺静脉隔离 (PVI) 结合左心房关闭 (LAAC) 与肺静脉隔离 (PVI) 的结合,与单独使用LAAC相比,没有增加并发症或减少血栓事件. 然而,联合手术显示心脏功能得到改善,这表明潜在的长期益处.
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:
- 与肺静脉隔离 (PVI) 结合的左心房尾关闭 (LAAC) 是有效和安全的.
- 对LAAC和PVI相结合的长期比较数据与LAAC单独的数据是有限的.
- 这项研究比较了联合LAAC-PVI与单独使用LAAC的长期结果.
研究的目的:
- 评估LAAC和PVI相结合的长期结果与单独的LAAC.
- 为了比较临床事件,包括血栓事件,MACCE,再住院和心房低心率.
- 为了评估出血事件,周围设备并发症和AF复发率.
主要方法:
- 倾向分数匹配 (PSM) 用于从333名非膜动患者中创建可比较的组.
- 包括153名PSM后患者:102名在LAAC-PVI组合组,51名在LAAC单独组.
- 临床结果,出血和周围设备并发症进行了比较;单独的PVI组被纳入AF复发分析.
主要成果:
- 在PSM后的组之间没有显著的基线差异.
- 平均随访时间为37.6个月.
- 群体之间的血栓事件,MACCE,心血管疾病再住院,心房动脉冲动,出血和周围设备并发症的比较率.
- 组合手术组在12个月后改善了左心室喷射分数 (LVEF) (60.5%对57.2%,p=0.002).
结论:
- 与单独使用LAAC相比,联合LAAC和PVI并没有增加并发症,也没有在预防血栓/心血管事件方面提供显著的优势.
- 综合手术表明心脏功能得到改善,这表明潜在的长期心脏益处.
- 进一步的研究可能会澄清在LAAC程序中同时使用PVI的具体长期优势.
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