与传统的适应性节奏相比,闭环刺激可以降低心房高频发作的发生率,在患有鼻节功能障碍的患者中
Ennio C L Pisanò1, Valeria Calvi2, Miguel Viscusi3
1Cardiology and Intensive Care Unit, Vito Fazzi Hospital, Lecce, Italy.
概括
与传统节奏相比,闭环刺激 (CLS) 在心脏起器患者中显著减少了心房高频发作 (AHREs). 这一发现表明,CLS可能会改善鼻节功能障碍患者的结果.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 电子生理学 电子生理学
背景情况:
- 亚临床心房动 (AF) 增加了临床AF,中风和心血管死亡的风险.
- 患有鼻节功能障碍 (SND) 的心脏起器患者容易发生AF进展.
- 传统的双室速率适应 (DDDR) 节奏可能无法完全减轻AF风险.
研究的目的:
- 评估与心内阻抗监测相结合的闭环刺激 (CLS) 是否能减少DDDR心脏起器患者心房高频发作 (AHREs).
- 为了比较CLS与传统DDR节拍在预防心血管不良事件中的有效性.
主要方法:
- 在612名接受双腔CLS和598名接受基于加速度计的DDR节奏的患者中进行了随机试验.
- 随访时间为3年.
- 主要终点:到第一个AHRE (≥6分钟) 的时间,中风或暂时性缺血性发作 (TIA);通过心脏内电图进行判断.
主要成果:
- 主要终点发生在50.6%的CLS组中,而在DDR组中为55.7%.
- 通过CLS显著减少了持续6小时至7天的AHRE (HR 0.84,P=0.033).
- 在没有心房阻塞或先前AF史的患者中,益处最大.
结论:
- 双腔CLS在SND患者中显示AHRE发生率明显低于传统DDR节奏相比.
- CLS可能为管理亚临床AF和相关风险提供了改进的节奏策略.
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