无心脏起器与输血动脉起器之间的患者结局的比较,经过过导管大动脉置换后的患者结局
Hiroki A Ueyama1, Yoshihisa Miyamoto2, Kenji Hashimoto3
1Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
JACC. Cardiovascular interventions
|July 18, 2024
概括
无心脏起器越来越多地用于通过导管的大动脉替换 (TAVR) 后的导电问题. 与静脉输血起器相比,它们的住院和设备并发症率较低,中期死亡率相似.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预程序 干预程序
背景情况:
- 关于无心脏起器 (LP) 的有效性,有有限的证据存在.
- 导电障碍是TAVR手术后的一个已知的并发症.
- 评估替代步调策略对于患者的治疗结果至关重要.
研究的目的:
- 分析TAVR后无心脏起器植入的国家趋势.
- 为了在这个患者群体中比较无心脏起器与静脉输入心脏起器的性能和安全性.
主要方法:
- 从2017年到2020年对医疗保险受益者 (≥65岁) 的回顾性分析.
- 包括TAVR后接受无或静脉输入心脏起器的患者.
- 使用的倾向性得分重叠权重用于对结果的比较分析.
主要成果:
- 在TAVR后,在2017-2020年间,无心脏起器使用量增加了3.5倍.
- 无心脏起器与较低的住院整体并发症 (7.2%与10.1%) 有关.
- 中期分析显示,死亡率或心力衰竭住院病例没有显著差异,但无心脏起器的设备相关并发症较低.
结论:
- 无心脏起器越来越多地被用于TAVR后的导电干扰.
- 无心脏起器在医院和与设备相关的并发症方面显示出更好的安全性.
- 在TAVR后,无和透静脉节奏策略之间的中期死亡率没有显著差异.
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