节奏QRS形态模仿完整的左捆分支阻塞,由右心室节奏诱导,与节奏诱导的心肌病相关
Shota Ikeda1,2, Kazuo Sakamoto1, Masafumi Sugawara2,3
1Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Journal of cardiovascular electrophysiology
|March 4, 2024
概括
节奏诱导心肌病 (PICM) 的风险更高,QRS形态模仿完整的左捆分支块 (CLBBB). 建议避免这种特定的右心室节奏模式,并仔细跟踪患者.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心血管医学 心血管医学
背景情况:
- 右心室 (RV) 节奏可以导致左心室 (LV) 系统功能障碍,称为节奏诱导心肌病 (PICM).
- 节奏QRS形态对PICM发展的具体影响尚不清楚.
- 这项研究调查了类似CLBBB的节奏QRS和PICM之间的关联.
研究的目的:
- 为了确定QRS形态是否类似于完整的左捆分支块 (CLBBB) 在右心室节奏期间与节奏诱导心肌病 (PICM) 相关.
- 在接受心脏起器植入的患者中识别PICM发展的潜在风险因素.
主要方法:
- 在2010-2020年间对270名心脏起器植入的患者进行了回顾性分析.
- 纳入标准:先进的心房阻塞或心房动与心房动,基线LV喷射率 (LVEF) ≥50%,心声图 ≥6个月植入后.
- 节奏QRS形态被归类,PICM被定义为LVEF≥10%降低至<50%.
主要成果:
- 在270名患者中,PICM观察到38名患者.
- 在患有PICM的患者中经常观察到类似CLBBB的节奏QRS形态.
- 多变量分析确定了基线低的LVEF和CLBBB类节奏QRS作为PICM的显著预测因素 (OR:2.69,P=.011).
结论:
- 类似于CLBBB的节奏QRS形态可能成为PICM的新风险因素.
- 应考虑避免导致CLBBB类QRS的RV步调,以避免出现CLBBB类QRS.
- 患有CLBBB类节奏QRS的患者需要密切监测PICM的发展.
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