过早心房收缩的更高频率与密码性中风后心房的检测相关
Yuki Shimada1, Kenichi Todo1, Ryosuke Doijiri2
1Department of Neurology, Osaka University Graduate School of Medicine, Japan (Y.S., K.T., Y.G., S.O., T.S., H.M.).
Stroke
|March 4, 2024
概括
过早心房收缩 (PAC) 的频率与密码性中风患者的心房动 (AF) 检测有剂量相关性. 较高的PAC率显著增加了AF检测和负担,有助于评估中风风险.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 隐蔽心房动 (AF) 是密码性中风的主要原因.
- 在这些患者中确定AF的预测因子对于预防中风至关重要.
研究的目的:
- 为了研究早收缩 (PAC) 频率和AF检测之间的剂量依赖关系.
- 评估PAC频率是否预测密码性中风患者使用可插入心脏监测器 (ICM) 的AF负担.
主要方法:
- 连续发生密码性中风的ICM患者根据24小时的霍尔特ECGPAC计数 (≤200,>200-≤500,>500) 进行分组.
- 使用存活率分析和后勤回归,评估了AF检测率和高AF负担 (超过累计持续时间的中位数).
- 分析根据年龄,性别和CHADS2分数进行了调整.
主要成果:
- 较高的PAC频率与ICM增加的AF检测率相关 (15.5%/年在低PAC组与71.4%/年在高PAC组).
- 与低PAC组相比,中度 (2.11) 和高 (3.23) PAC组的AF检测调整后危险比率明显高.
- 高 AF 负担的调整后赔率比率在中度 (2.57) 和高 (4.25) PAC 组中也显著增加.
结论:
- 在密码性中风患者中,PAC频率与AF检测有显著的剂量依赖关联.
- 通过霍尔特心电图识别的PAC可以作为ICM监测中风患者的AF检测和负担的有价值预测指标.
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