在患有心房的高风险患者中,结合导管切除和左心房尾封闭:倾向性得分匹配分析
Ziyong Hao1, Bin Liu1, Xiaoyi Xie2
1Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
概括
对心房动 (AF) 患者来说,将导管切除 (CA) 与左心房附属物封闭 (LAAO) 结合在一起是安全的. 这种方法可能会减少心力衰竭住院,尽管它会增加周围设备的泄漏.
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:
- 导管切除 (CA) 和左心房附属物阻塞 (LAAO) 与单独的LAAO对心房 (AF) 患者的联合安全性和有效性尚未得到充分证实.
- 评估了接受LAAO治疗的AF患者和增加中风风险的患者.
研究的目的:
- 在AF患者中,将CA和LAAO联合方法的安全性和有效性与单独的LAAO进行比较.
- 评估一个复合的终点,包括死亡,血栓栓塞事件,严重出血,心力衰竭 (HF) 再住院和周围手术并发症.
主要方法:
- 总共有707名接受LAAO治疗的AF患者被分析.
- 倾向性得分匹配创建了两个组:单独LAAO (83名患者) 和联合CA和LAAO (83名患者).
- 主要终点是死亡,血栓塞栓事件,严重出血,HF再住院和主要周围手术并发症的复合,随访时间中位数为2年.
主要成果:
- 在所有患者中都取得了成功的LAAO,周围手术并发症率相似较低 (2.4%对4.8%).
- 在组合组中,周围设备的泄漏率显著更高 (25.3%对43.4%,p=0.01).
- 组之间主要复合终点没有显著差异 (22.2%对14.3%,p=0.63),但HF再入院在组合组 (19.6%对3.6%,p=0.024) 中明显较低.
结论:
- 结合CA和LAAO的"一站式"方法对AF患者来说是安全的.
- 这种综合策略在减少心力衰竭症状和住院治疗方面提供了额外的好处.
- 在结合CA和LAAO时,增加周边设备泄漏的发生率是需要考虑的.
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