在急性心肌梗塞后左心室缩性功能丧的患者的编程电刺激期间偶然诱导的心房动
Tharsika Sakthivel1, Niels Risum1, Henning Bundgaard1
1Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark.
概括
在心肌梗塞后患者中,随机心房 (AF) 在编程电刺激期间,心肌梗塞后患者的射出分数减少,并没有增加长期AF风险. 这一发现表明,PES期间偶然发生的AF并不是未来心脏事件的重要预测因素.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 临床研究 临床研究
背景情况:
- 患有心肌梗塞 (MI) 后左心室缩功能障碍的患者有心律不整的风险.
- 编程电刺激 (PES) 用于评估心律失常风险.
- 在此人群中,PES期间偶然诱导的心房 (AF) 的临床意义尚未明确.
研究的目的:
- 调查在PES期间偶然诱导的AF的长期临床影响.
- 为了确定在PES期间偶然的AF是否预测未来的AF,其他心律失常,或心血管重大事件 (MACE) 在后心脏病发作患者减少射出分数.
主要方法:
- 这项研究包括来自CARISMA研究的231名患者,他们的LVEF≤40%并且没有先前的AF史.
- 患者在心脏病发作后6周接受了PES,并接受了可植入心脏监测器 (ICM) 进行2年的连续监测.
- 在PES期间记录和分析了与长期结果相关的偶然AF.
主要成果:
- 在231名患者中,61人 (26%) 在2年内发展出AF;10人在PES期间有偶然的AF.
- 在PES期间偶然的AF与长期AF风险显著增加无关 (HR 1.6 [0.9-3.0],p=0.14).
- 在患有或不患有偶发性AF的患者之间,没有观察到腹节律失常,心室节律失常或MACE的风险的显著差异.
结论:
- 随机诱导的AF在PES期间在后MI患者中减少LVEF并没有显着与AF的长期风险增加有关.
- 这一发现表明,在PES期间偶然发生的AF可能不是这种特定患者群体未来心律不整或MACE的强有力的预测因素.
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