在初级预防中非侵入性程序化刺激的预后价值 植入式心脏转换器-除器接受者
Piotr Futyma1,2, Pasquale Santangeli3, Łukasz Zarębski1,2
1St. Joseph's Heart Rhythm Center Rzeszów Poland.
Journal of arrhythmia
|June 28, 2024
概括
在患有初级预防植入式心脏转换器-除器 (ICD) 的患者中,非侵入性编程腹腔刺激 (NIPS) 可以预测未来的死亡率. 在缺血性心肌病患者中,NIPS诱导的腹腔动心/心 (VT/VF) 表明风险更高.
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:
- 植入式心脏转换器-除器 (ICD) 允许通过非侵入性编程心室刺激 (NIPS) 进行心室低心率 (VT) 或心室动 (VF) 诱导性研究.
- 在初级预防ICD患者中,NIPS对未来心律失常事件或死亡率的预测价值仍未得到检查.
研究的目的:
- 调查NIPS是否可以预测接受ICD用于初级预防的患者未来心律失常事件或死亡率.
主要方法:
- 该NIPS-ICD研究招募了41名初级预防ICD患者 (76%是缺血性心肌病 [ICM]).
- 患者接受了NIPS,在不同的驱动周期长度下多达三次过早的外刺激.
- 如果诱导持续的VT或VF,NIPS是阳性;主要终点是随访期间持续的VT/VF发生.
主要成果:
- 在基线时,VT/VF在20%的ICM患者中被诱导.
- 在5年内,17%的患者经历了静脉动/静脉动,所有患者都属于ICM组.
- 虽然VT/VF发生在NIPS诱导和非诱导患者之间没有显著差异 (38%对12%,p=.11),但NIPS诱导组的死亡率明显高 (38%对12%,p=.043).
- 静脉/静脉瘤复发或死亡的综合终点在NIPS诱导性ICM患者中最常见 (75%对35%,p=.037).
结论:
- 在ICM的初级预防ICD患者中,NIPS期间的VT/VF诱导性与长期死亡率的增加有关.
- NIPS可能成为这些患者风险分层的一个有价值的工具.
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