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在接受心脏再同步治疗的患者中,左束枝区域节奏与双心室节奏的有效性:选择地点 - 队列研究

Jenish P Shroff¹, Deep Chandh Raja², Lukah Q Tuan¹

¹School of Medicine and Psychology, Australian National University, Australian Capital Territory, Australia; Canberra Heart Rhythm, Australian Capital Territory, Australia.

|February 17, 2024

概括

左捆支部区域节奏 (LBBAP) 为心脏再同步治疗 (CRT) 提供了比双心室节奏更有效的替代方案. 与传统的CRT相比,LBBAP-CRT显著改善了心脏功能,生活质量,并减少了医疗保健利用率.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
心脏衰竭管理的管理

背景情况:

使用双心室 (BiV) 节奏的心脏再同步治疗 (CRT) 是心力衰竭的标准,但大约三分之一的患者没有反应.
左捆分支区域步调 (LBBAP) 已成为一种潜在的替代步调策略.

研究的目的:

评估永久LBBAP-CRT作为BiV节奏的替代品的可行性和临床有效性.
在心力衰竭患者中比较LBBAP-CRT与BiV-CRT的结果.

主要方法:

一项比较分析包括接受BiV-CRT的50名患者和接受LBBAP-CRT的51名患者,这些患者来自479名转诊心力衰竭患者中.
临床评估包括生活质量 (QoL) 调查,左心室功能的心声扫描和纽约心脏协会 (NYHA) 课程,在基线和6个月间隔记录.

主要成果:

两个节奏组在左心室喷射分数,末缩体积,KOL和NYHA类中与基线相比显著改善.
在6个月和12个月后,LBBAP-CRT显示左心室喷射率的优异改善,以及左心室末缩体积的较大减少.
在LBBAP-CRT组 (71%) 与BiV-CRT组 (30%) 相比,在LBBAP-CRT组 (71%) 实现QRS持续时间<120毫秒显著更高. LBBAP-CRT也导致了更大的NYHA类和QoL改进,减少心力衰竭入院,减少医疗保健利用率.

结论:

左捆分支区域节奏-心脏再同步治疗 (LBBAP-CRT) 是BiV-CRT的一个可行和有效的替代方案.
LBBAP-CRT为生活质量提供了显著的改善,并减少了医疗保健利用率.
这种节奏策略可以被认为是BiV-CRT的替代品,或者是符合条件的患者的第一线治疗.

关键词:

双管节奏是指双管节奏.心脏再同步治疗心脏再同步治疗心脏衰竭是因为心脏衰竭.左捆分支机构地区步行步行.左捆的分支区块的分支区块.

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