左心室电延迟预测无心脏重同步治疗的体积反应
Nadeev Wijesuriya1, Vishal Mehta1, Felicity De Vere1
1King's College London, London, United Kingdom; Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom.
Heart rhythm
|August 29, 2024
概括
识别较长的左心室电延迟 (Q-LV) 预测了对无心脏再同步治疗 (CRT) 的更好的反应. 针对这些部位可能会改善接受无CRT的患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电子生理学 电子生理学
背景情况:
- 无左心室 (LV) 内心节奏是一种新兴的心脏再同步治疗 (CRT) 技术.
- 对无CRT反应的预测因素尚不清楚.
- 在增加电延迟 (Q-LV) 的部位植入LV内心节拍电极可以提高反应率.
研究的目的:
- 检查Q-LV与无CRT对心声回应重塑反应之间的关联.
- 调查WiSE-CRT系统与LV节拍地点选择有关的有效性.
主要方法:
- 对SOLVE-CRT试验的后期分析 (n=122).
- 在6个月内检查了LV刺激部位Q-LV和左心室末缩体积 (LVESV) 减少>15%之间的关系.
- 进行了多变量回归和接受器操作特征分析,并对缺血性心肌病进行了亚组分析.
主要成果:
- 总体而言,6个月LVESV应答率为46%.
- Q-LV是反应的独立预测指标 (调整后赔率比1.015;P = .05).
- 响应率在最高Q-LV四分位数 (64%) 与最低 (28%) (P <.01) 相比显著改善,特别是在缺血性心肌病中.
结论:
- 增加的Q-LV与无CRT后改善的反向重塑有关.
- 准高Q-LV的LV内心部位可能比实证植入提供额外的好处.
- 这一发现支持用于无CRT的个性化LV电极放置.
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