在接受植入式循环记录器治疗因不明原因昏迷的患者中,对心脏起器需求的预测因素:系统性审查和元分析
Jeremy William1, Shane Nanayakkara1, David Chieng2
1The Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; The Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia.
Heart rhythm
|March 20, 2024
概括
植入式循环记录器 (ILR) 有助于识别昏迷的原因. 老年,PR延长和导电疾病预测ILR患者的节拍器需求.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 植入式循环记录器 (ILR) 越来越多地用于诊断无法解释的昏迷.
- 识别心缩和永久起器 (PPM) 插入的预测因子对于患者管理至关重要.
- 高风险患者可能会从前置心脏起器植入中受益.
研究的目的:
- 进行系统审查和元分析.
- 在接受植入式循环记录器 (ILRs) 治疗不明原因昏迷的患者中,确定永久起器 (PPM) 插入的风险预测因子.
主要方法:
- 在2023年6月之前对电子数据库搜索 (MEDLINE,Embase,Scopus,Cochrane) 的系统审查和元分析.
- 包括对ILR接受者进行的研究,其中包括无法解释的昏迷和记录的PPM插入风险因素.
- 随机效应模型用于计算PPM要求的临床和心电学预测因素的聚合几率比率 (OR).
主要成果:
- 分析了8项研究,包括1007名ILR接受者;26.6%需要PPM插入.
- 年龄较大 (平均70.2岁) 和PR延长 (OR,2.91) 是PPM插入的重要预测因素.
- 远导系统疾病 (OR,2.88) 也预测了PPM的需要;鼻节功能障碍导致了62%的PPM.
结论:
- 大约25%的ILR接受者因不明原因的昏迷最终需要永久起器 (PPM).
- 对于PPM要求的关键预测因素包括晚年,基线PR延长和远端导电系统疾病.
- 这些发现有助于对昏迷患者进行分层,并指导治疗决策.
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