在心脏再同步治疗中,对同步的左心室节奏率与双心室节奏率的评估
Yuichiro Miyazaki1, Kohei Ishibashi2, Nobuhiko Ueda2
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Journal of cardiology
|April 28, 2024
概括
同步左心室节奏 (sLVP) 与自适应心脏再同步治疗 (aCRT) 算法改善了患者的治疗结果. 较高的sLVP率 (≥59.4%) 与更好的预后和CRT反应有关.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 生物医学工程 生物医学工程
背景情况:
- 适应性心脏再同步疗法 (aCRT) 使用同步左心室节奏 (sLVP) 来改善与内在右心室激活的融合.
- 虽然sLVP比双心脏节奏提供了优势,但改善临床结果的最佳sLVP率仍未确定.
研究的目的:
- 研究接受aCRT的患者的sLVP率和临床结果之间的关联.
- 为了确定预测心脏再同步治疗 (CRT) 响应的最佳sLVP速率值.
主要方法:
- 分析了2016年4月至2021年8月期间接受CRT植入的271名患者的队列.
- 对接受aCRT算法的63名患者进行了评估,随访时间中位数为316天.
- 统计分析包括接收器操作特征 (ROC) 曲线分析和多变量Cox危险分析.
主要成果:
- 在6个月的随访中,71%的患者被确定为CRT反应者.
- 与非响应者相比 (47% ± 40%,p=0.003),响应者表现出明显更高的sLVP率 (75% ± 30%).
- ≥59.4%的sLVP率被确定为预测CRT响应 (AUC=0.70) 的最佳值,并与更好的预后相关 (日志排名p<0.001).
结论:
- sLVP与CRT反应有显著的相关性.
- 在接受aCRT治疗的患者中,更高的sLVP率 (≥59.4%) 对于实现有利的预后至关重要.
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