优化患者选择的生理节奏在Bradyarrhythmia:与高心室节奏负担相关的因素
James Mannion1, Kathryn L Hong2, Amy Hennessey1
1Electrophysiology Department, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
Cardiology research
|April 22, 2024
概括
确定了高右心室节奏负担的预测因素. 男性性别,先前的冠状动脉旁路移植,以及缺乏模式切换算法与节奏负担增加有关,增加了节奏诱导心肌病的风险.
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:
- 右心室 (RV) 节奏是症状勃节律失常的常见策略.
- 高RV节奏负担可能导致节奏诱导心肌病 (PICM),左心室功能恶化.
- 在患有永久性心脏起器的患者中增加RV节奏负担的预测因素需要阐明.
研究的目的:
- 确定与超过20%的RV步调负担相关的因素.
- 确定患有PICM风险较高的患者群体.
- 为了告知减轻RV步调负担的策略.
主要方法:
- 236名心脏植入式电子设备 (CIED) 患者的回顾性队列研究.
- 分析病史,心电图,心声波,药物和心脏起器数据.
- 确定与心室节奏 (VP) 负担>20%相关的因素.
主要成果:
- 65%的患者有RV节奏负荷≥20%.
- 完全的心脏阻塞 (CHB) 和模式切换算法的缺失与高VP负担 (P=0.002和P<0.001分别) 密切相关.
- 男性性别和之前的冠状动脉旁路移植 (CABG) 也与VP负担>20%有显著的关联.
结论:
- 高度心房 (AV) 阻塞与增加RV节奏负担有关.
- 男性性别,先前的CABG和缺乏模式切换算法是高RV节奏负担的独立预测因素.
- 这些发现有助于识别患有PICM风险的患者,并优化节奏策略.
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