在左心室辅助装置 (LVAD) 植入后发生电风暴
Suganya Karikalan1, Min Choon Tan1, Nan Zhang2
1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona, USA.
Journal of cardiovascular electrophysiology
|April 9, 2024
概括
左心室辅助装置 (LVAD) 植入后的电风暴 (ES) 影响7%的患者,通常在30天内. 腹腔失律史和ICD冲击是危险因素,ES与生存率降低有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电力生理学 电力生理学
背景情况:
- 电风暴 (ES) 是左心室辅助器件 (LVAD) 植入后经常出现的并发症.
- 影响ES和患者结果的因素需要进一步调查.
- 了解ES预测因素和生存影响对于管理LVAD患者至关重要.
研究的目的:
- 在接受LVAD植入的患者中识别与电风暴 (ES) 相关的因素.
- 为了确定患有ES的LVAD患者的生存概率.
- 为了分析三个高等中心的15年队列.
主要方法:
- 在2006年至2020年期间接受LVAD的883名患者的回顾性队列研究.
- 在24小时内,ES被定义为≥3个持续的腹腔动心节拍发作,没有可逆原因.
- 通过全面的电子健康记录和外部医疗记录审查收集的数据.
主要成果:
- ES发生在7%的患者身上,LVAD后的中位数发病时间为13天.
- 57%的ES病例发生在30天内,而43%发生在晚些时候.
- 在植入前,心室失常和ICD冲击的病史是ES的重要风险因素.
- ES与1.92倍的死亡风险增加有关 (95% CI:1.39-2.64,p <.001).
结论:
- 在LVAD植入后ES的发生率为7%,大多数事件发生在第一个月内.
- 预先存在的心室节律失常和先前的ICD冲击是ES的关键预测因素.
- 电风暴显著降低了LVAD接受者的生存率.
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