"Ablate and Pace"与传导系统步调:同时进行与延迟的心房结结除除除除术
Pietro Palmisano1, Matteo Ziacchi2, Gabriele Dell'Era3
1Cardiology Unit, "Card. G. Panico" Hospital, 73039 Tricase, Italy.
Journal of clinical medicine
|April 27, 2024
概括
导管系统与同时进行心房结切除的节奏与延迟手术一样安全. 这种综合方法减少了对心房患者的住院治疗和医疗保健资源利用.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 症状性,耐火性心房动 (AF) 带来了重大的临床挑战.
- 导导系统节奏 (CSP) 和心房结切除 (AVJA) 是AF的确立治疗方法.
- 与CSP植入相比,AVJA的最佳时间 (同时 vs 延迟) 仍然不清楚.
研究的目的:
- 为了比较同步AVJA与延迟AVJA在CSP植入后的安全和医疗保健资源利用情况.
- 为了评估接受这两种策略的患者的长期结果.
主要方法:
- 一个前性的,多中心的观察性研究.
- 招募了147名具有症状,耐火性AF的患者.
- 患者接受了同时的CSP植入和AVJA (同时组,n=105) 或在CSP植入后几周进行AVJA的分阶段手术 (延迟组,n=42).
主要成果:
- 同时 (3.8%) 和延迟 (2.4%) AVJA 组之间的与程序相关的并发症率相似 (p=0.666).
- 同时使用AVJA的组显示每位患者的手术相关住院病例显著减少 (1.0对2.0,p<0.001).
- 同时使用AVJA也导致每名患者住院治疗日数减少 (4.7比7.4,p<0.001).
结论:
- 同时的AVJA是延迟AVJA的安全替代品,用于接受CSP的患者.
- 与CSP植入同时执行AVJA可以减少医疗保健资源的利用.
- 这一策略在治疗耐性心房患者方面具有潜在的好处.
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