在患有心脏沙丘病症的患者中,右束支柱阻塞和心室节律失常之间的关联
Yu Yamada1, Kimi Sato1, Masayoshi Yamamoto1
1Department of Cardiology, Institute of Medicine; University of Tsukuba, Tsukuba, Japan.
JACC. Advances
|August 6, 2024
概括
右束支部阻塞 (RBBB) 是患有心脏沙丘病症 (CS) 的患者严重腹腔失常事件 (SVAE) 的独立预测因子. 这一发现可能表明在腹腔间隔膜内存在特定的痕模式.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏成像 - - 心脏成像
背景情况:
- 静脉节律失常 (VA) 在心脏沙尔科毒症 (CS) 中构成危及生命的风险.
- 右束分支阻塞 (RBBB) 是CS中常见的导电异常,但其与VA的联系尚未得到充分确立.
研究的目的:
- 为了调查RBBB和VA在被诊断为CS的患者中发生的发生之间的关联.
主要方法:
- 对多中心,回顾性ILLUMINATE-CS研究的后期分析.
- 根据诊断,患者被分为RBBB和非RBBB组.
- 严重心室失常事件 (SVAE) 是主要结局,由心脏死亡,心室动,持续心室低心率或适当的ICD治疗定义.
主要成果:
- 在312名患者中,155名 (49.7%) 患有RBBB.
- 在心脏MRI上,RBBB组表现出基底室间隔膜 (IVS) 稀疏度增加和晚期加多增强.
- 在中位数为3.0年的随访期间,RBBB独立地与较高的SVAE发病率相关 (HR:1.93;P=0.015).
结论:
- RBBB 作为在心脏沙丘病患者中SVAE的独立预测器.
- 这种关联可能归因于心肌痕的特定模式,主要在IVS.
相关概念视频
Mechanism of Cardiac Arrhythmias
908
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.
908
Disturbances in Heart Rhythm
924
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...
924
ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
203
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,...
203
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.3K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.3K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
720
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
720
Conduction System of the Heart
887
The cardiac conduction system produces and transmits electrical impulses that prompt myocardial contraction, ensuring efficient heart function. This intricate system ensures that the heart beats in a coordinated and efficient manner, beginning with the atria and then the ventricles. The conduction system optimizes cardiac output by maintaining this precise sequence, which is crucial for adequate blood circulation.
This system relies on the unique properties of nodal and Purkinje cells:...
This system relies on the unique properties of nodal and Purkinje cells:...
887


