转换到异常性心房动患者的鼻节律在心房节切除后与导电系统节奏调节
Maja Ivanovski1,2, Miha Mrak1, Anja Zupan Mežnar1
1Department of Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Reviews in cardiovascular medicine
|July 30, 2024
概括
随着传导系统节奏的放大,心房结节切除后自发转换为鼻腔节律是可能的,发生在8.8%的患者中. 较小的左心房体积指数预测了成功的转化,突出了未来研究的关键因素.
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:
- 当标准治疗失败时,心房动 (AF) 管理通常需要先进的策略.
- 使用心房结节切除 (AVNA) 与导电系统节奏 (CSP) 的"切除和节奏"方法提供了生理左心室激活.
- 目前尚不清楚AVNA与CSP后自发转化为鼻腔节律 (SR) 的速率.
研究的目的:
- 确定AVNA与CSP后自发SR转换的发生率.
- 在接受AVNA与CSP的患者中识别自发SR转换的预测因子.
主要方法:
- 对耐火性症状性AF患者进行AVNA与CSP的回顾性分析 (2018年6月 - 2022年12月).
- 在后续访问时进行心电图 (ECG) 分析.
- 在基线和植入后六个月内对心声学和临床参数的评估.
主要成果:
- 在68名患者 (6名患者) 中,自发SR转化发生在8.8%的患者中.
- 较小的左心室体积指数 (LAVI) 与SR转换有显著的关联 (p=0.002).
- 在SR或非SR组的随访期间,没有观察到LAVI的显著变化.
结论:
- 在AVNA与CSP后自发SR转换是可行的,特别是在左心房较小的患者中.
- 需要进一步的研究来指导设备选择,以在潜在的SR修复器中获得最佳心房同步.
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