与被动固定四极管相比,主动固定四极管左心室在心脏再同步治疗中的临床有用性
Akinori Wakamiya1, Kohei Ishibashi1, Satoshi Oka1
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
概括
与传统的被动固定导线相比,ASQ左心室导线显示出更好的稳定性和更少的并发症. 这种新型的活性固定为心脏再同步治疗提供了潜在的更安全的选择.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医疗器械 医疗器械
背景情况:
- 心脏再同步治疗 (CRT) 依赖于有效的左心室 (LV) 置.
- 传统的被动固定线索在稳定性和并发症率方面存在局限性.
- 新型主动固定线索旨在改善LV线索性能和患者的治疗结果.
研究的目的:
- 为了比较Medtronic Attain Stability Quad (ASQ) 的稳定性和性能,主动固定LV线与传统的被动固定线进行比较.
- 评估接受CRT的患者中LV相关并发症的发生率.
- 为了确定ASQ带头是否能显著减少并发症.
主要方法:
- 一项涉及183名接受CRT植入的患者的比较研究.
- 患者被分为两组:接受ASQ导向 (n=69) 的患者和接受常规被动固定导向 (非ASQ,n=114) 的患者.
- 植入后监测了包括节奏捕获值 (PCT) 升高,神经刺激 (PNS) 和LV脱离在内的并发症.
主要成果:
- 与非ASQ组 (30%;P=0.019) 相比,ASQ组的LV相关并发症 (14%) 显著减少.
- 在非ASQ组中,LV的脱落只发生在非ASQ组中.
- 在ASQ组中,PCT水平的升高明显较低 (7%对23%;P=0.007).
- 卡普兰-梅尔和考克斯回归分析证实,ASQ的相关并发症发生率显著降低.
结论:
- 达到稳定性四元体 (ASQ) 领先者表现出卓越的表现,需要干预或调整的并发症较少.
- 领先的ASQ与LV领先相关并发症的显著减少有关.
- 由于其增强的稳定性和安全性,ASQ代表了CRT设备植入的有利选择.
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