患有埃布斯坦异常的成年人中心房律乱的危险因素
Irene Martin de Miguel1, William R Miranda1, Malini Madhavan1
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JACC. Advances
|June 28, 2024
概括
在埃布斯坦异常 (EA) 中,心房失常 (AA) 是常见的. 对心房功能的心声测量可以帮助识别患有新发或复发AA风险的患者,改善风险分层和治疗指导.
科学领域:
- 心脏病学 心脏病学
- 医学诊断 医学诊断 医学诊断
- 心脏电生理学 心脏电生理学
背景情况:
- 大心律不整 (AA) 是埃布斯坦异常 (EA) 的常见并发症.
- 了解EA患者中AA的特定风险因素对于有效管理至关重要.
- 之前的研究还没有完全阐明这个人群中AA的预测因素.
研究的目的:
- 为了确定EBSTEIN异常患者在基线时AA的患病率.
- 在随访期间识别与AA初始发生 (发生率) 相关的风险因素.
- 为了确定与患有先前存在的心房失常症的患者中复发性AA相关的危险因素.
主要方法:
- 从2003年到2020年在梅奥诊所接受治疗的成年EA患者的回顾性分析.
- AA定义为心房动 (AF) 或心房/心跳动 (AFL).
- 收集的数据包括临床,心声回声,节律和手术信息.
主要成果:
- 在682名EA患者中,34%的患者具有基线AA (18%AF,21%AFL);风险因素包括年龄和心房体积/应变.
- 在以前没有受到影响的患者中,新的AF的10年累积发病率为16%,AFL为22%.
- 发生性AF的危险因素是年龄较大和右心房储菌株;对于AFL,心房隔膜缺陷,左心房体积和男性性别.
- 40%的基线AA患者出现了复发;年龄较大和右心房储菌株预测了复发的AF.
结论:
- 患有埃布斯坦异常的患者面临着新的和复发性心房律乱的显著风险.
- 在EA中,心房动和心房/心发生的频率相似,即使在较年轻的年龄.
- 心房功能的心声学指数对于识别有风险的患者是有价值的,有助于风险分层和治疗决策.
相关概念视频
01:28Mechanism of Cardiac Arrhythmias
910
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
910
01:28Disturbances in Heart Rhythm
933
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
933
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
209
Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
209
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
735
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
735
01:14Decreased pulse rate
536
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
536
01:28Electrocardiogram Fundamentals
559
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
559