左束枝区域节奏和右心室节奏之间的比较:心室电力学同步和心房高频发作的风险
Wang-Yang Yang1, Bei-Bing Di1, Hui Peng1
1Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Frontiers in cardiovascular medicine
|May 10, 2024
概括
与右心室节奏相比,左束支部区域节奏 (LBBAP) 改善了心室同步并减少了心房高频发作 (AHREs). 这项研究证明了LBBAP.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏节拍是因为心脏节拍.
背景情况:
- 右心室节奏 (RVP) 可能导致机电失调,对临床结果产生负面影响.
- 与RVP相比,左捆分支区域步调 (LBBAP) 显示出有希望的步调参数.
研究的目的:
- 为了比较 LBBAP 和 RVP 之间的心室电力学同步.
- 在接受LBBAP和RVP的患者中调查心房高频发作 (AHREs) 的风险.
主要方法:
- 40名心房阻塞和没有先前心房的患者被分为LBBAP和RVP组 (RVA和RVS子组).
- 用心电图和二维斑点跟踪心电图 (2D-STE) 评估了心室电机同步.
- AHREs被定义为心房频率≥176 bpm持续≥6分钟,由心脏起器记录.
主要成果:
- 与RVA (164.73毫秒) 和RVS (148.23毫秒) 相比,LBBAP导致节奏较短的QRS持续时间 (113.56毫秒).
- 与RVA和RVS组相比,LBBAP表现出更好的同步,证实了较短的TDmax,SD的时间到缩应变峰值,以及SPWMD.
- 腹腔间机械延迟 (IVMD) 在LBBAP组明显较短 (-5.38毫秒),而不是RVA (44.82毫秒) 和RVS (25.31毫秒).
- 与RVA (36.4%) 和RVS (61.5%) 患者相比,LBBAP (12.5%) 的AHRE发病率较低.
- 与RVP相比,LBBAP独立地与AHRE风险降低有关 (日志排名p=0.043).
结论:
- 与传统的RVP相比,LBBAP促进了更窄的QRS持续时间和更高的心室同步.
- 与RVP相比,LBBAP与心房高频发作 (AHREs) 的风险降低有关.
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