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左捆支部区域步调中的性别差异与心脏再同步治疗的双管节步调对比

Usha B Tedrow¹, Andres F Miranda-Arboleda¹, William H Sauer¹

¹Cardiac Arrhythmia Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

JACC. Clinical electrophysiology

|June 6, 2024

概括

男性和女性在心脏再同步疗法 (CRT) 的左捆支部区域节奏 (LBBAP) 中表现出类似的结果. 对于男性来说,LBBAP的好处比双心室节奏控制 (BIVP) 更大,减少了心力衰竭住院和死亡率.

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:

一般来说,女性比男性更好地响应双心室节奏 (BIVP).
在BIVP中存在基于性别的导电差异.
左捆分支区域节奏 (LBBAP) 提供直接导电系统捕获.

研究的目的:

为了比较LBBAP与BIVP对初始心脏再同步治疗 (CRT) 的反应中的性别差异.

主要方法:

一个多中心的前性注册表包括了减少喷射分数和导电异常的患者.
患者接受LBBAP或BIVP作为最初的CRT.
主要结局是心力衰竭住院或全因死亡率;安全性评估与程序相关的并发症.

主要成果:

在LBBAP的初级结果中没有显著的性别差异.
与接受BIVP (P=0.03) 的男性相比,女性使用BIVP的初级结局较少 (P=0.03).
在男性中,使用LBBAP (29.9%) 与BIVP (46.5%) (P=0.004) 相比,LBBAP的初级结局率较低.
女性在LBBAP (24.14%) 和BIVP (36.2%) (P=0.23) 之间的主要结局没有显著差异.
所有组的并发症率在所有组中都相似.

结论:

对于接受CRT的男性和女性来说,LBBAP和BIVP的临床结果类似.
与BIVP相比,LBBAP显著降低了男性的心力衰竭住院和死亡率.
在女性中,没有观察到LBBAP和BIVP之间的结果有显著差异.

关键词:

双心室节奏是指双心室节奏.心脏再同步治疗心脏再同步治疗心脏衰竭是因为心脏衰竭.左捆分支机构地区节奏节奏.左心室喷射分数的部分.

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