非复杂的心室心律不整,与在1年后的复发性外周病变的更大自由相关的 mitra修复手术
Dimosthenis Pandis1, Navindra David2, Ahmed Ei-Eshmawi1
1Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
JTCVS open
|July 17, 2024
概括
在大多数患有心律不整的 mitra valve 脱落的患者中, mitra valve 修复手术显著减少了腹腔失常 (VA). 然而,复杂的基线VA独立预测了复发,强调了早期干预的必要性.
科学领域:
- 心血管外科心血管外科
- 电子生理学 电子生理学
- 心脏成像 - - 心脏成像
背景情况:
- 节律失常的米特拉脱落 (MVP) 构成心室节律失常 (VA) 的风险.
- mitra valve (MV) 手术对这些患者VA自然病史的影响尚不清楚.
- 在外科手术中修复关节后评估VA复发对于风险分层至关重要.
研究的目的:
- 在心律不整的MVP患者中,评估心室失常 (VA) 的累积发病率,在两心 (MV) 修复一年后.
- 为了确定VA复发后MV修复的预测因素.
主要方法:
- 连续62名被诊断为心律失常的MVP患者进行可选MVP修复的回顾性审查.
- 在手术后的30天和1年内评估VA复发.
- 基线特征的分析,包括VA复杂性和心肌痕存在的Lown-Wolf等级.
主要成果:
- 一年后,75.9%的患者没有复发的VA.
- 复杂的基线VA (低等级≥3) 是VA复发的最强的独立预测因子 (HR 10.8,P=.024).
- 患者与轻微的基线VA均没有VA后修复.
结论:
- 外科手术的额头骨修复在大多数心律失常的MVP患者中有效地减少VA.
- 术前复杂的VA是额头骨修复后复发的重要风险因素.
- 对于MVP和渐进性VA患者来说,早期识别和转诊至关重要.
相关概念视频
01:28Disturbances in Heart Rhythm
930
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...
930
01:28Mechanism of Cardiac Arrhythmias
909
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.
909
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
208
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,...
208
01:30Cardiac Action Potential
1.3K
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
1.3K
01:19Electrophysiology of Normal Cardiac Rhythm
2.9K
The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
2.9K
01:25Correlation between ECG and Cardiac Cycle
4.0K
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
4.0K