根据左心室缩性功能障碍的严重程度在心脏沙尔科毒性病中的心律失常预后
B Michelle Kim1, Daniel Sykora2, Andrew N Rosenbaum2
1Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
Heart rhythm
|August 29, 2024
概括
减少喷射率 (LVEF) 和植入式心脏转换器-除器 (ICD) 的心脏瘤患者面临高心室失常风险. 二次预防ICD与这些患者的最高风险有关.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- Sarcoidosis 的研究研究.
背景情况:
- 目前的指导方针为心脏沙丘病 (CS) 患者的植入式心脏转换器-除器 (ICD) 使用提供了多种建议,心脏沙丘病患者的左心室喷射率 (LVEF) <50%.
- 这凸显了在这种患者群体中需要更清晰的风险分层.
研究的目的:
- 在接受ICD的CS患者中调查心室心律失常的风险.
- 根据不同程度的左心室缩功能障碍 (LVEF ≤35%与36%-49%) 和ICD指示 (初级与二级预防) 来比较这一风险.
主要方法:
- 该研究分析了61名在初始评估时ICD和LVEF<50%的CS患者.
- 主要结局是ICD植入后没有持续性心室动脉冲动 (VT) /心室动 (VF) 的存活率.
- 对LVEF组和初级与二级预防指示进行了比较分析.
主要成果:
- 在单变量分析中,在LVEF≤35%和36%-49%组之间没有发现VT/VF风险的显著差异.
- 在多变量分析 (HR 2.86,P=.015) 中,二次预防ICD指标是持续静脉动/静脉动事件的唯一显著预测因素.
- 与初级预防 (0.11事件/患者年) 相比,接受ICD二次预防的患者的VT/VF事件负担较高 (0.47事件/患者年).
结论:
- 患有LVEF36% - 49%的心脏沙丘病患者表现出与LVEF≤35%的患者相似的高心律失常风险.
- 接受ICD二次预防的患者表现出心室心律失常的总体风险最高.
- 这些发现表明,需要重新考虑当前关于在CS患者中植入ICD的指南,这些患者的LVEF不同.
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