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双腔与单腔心脏起器在患有心房静脉阻塞的鼻节律患者中:全国范围的队列研究

Alexandre Bodin¹, Ivann Texier¹, Arnaud Bisson¹

¹Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Faculté de Médecine, Université François Rabelais, 37000 Tours, France.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

|September 13, 2024

概括

双腔起器显著降低了与单腔起器相比,完全心房阻塞和鼻节律的患者的死亡率和不良事件. 这项研究支持当前的指导方针,有利于双腔心脏起器植入,以改善患者的治疗结果.

科学领域:

心脏病学心脏病学
医疗器械医疗器械
临床研究临床研究

背景情况:

完整的心房静脉阻塞 (AVB) 与鼻节律往往需要心脏起器植入.
目前的指导方针建议使用双腔起器而不是单腔起器,但对硬性临床结果的强有力的证据有限.

研究的目的:

评估双腔心脏起器与单腔心脏起器在患者的长期临床有效性和安全性,完整的AVB和潜在的鼻节律.

主要方法:

使用法国国家行政数据库 (2013-2022) 进行的回顾性观察研究.
包括初级心脏起器植入的患者,以获得完整的AVB和鼻节律.
倾向性得分匹配,创建可比较的双腔和单腔心脏起器接受者组 (每组19,219名患者).

主要成果:

双腔起器与显著降低全因死亡率 (9.22%/年 vs 11.48%/年;HR 0.807) 和心血管死亡率 (HR 0.766) 相关.
在双室组中观察到心力衰竭 (HR 0.908),心房动 (HR 0.778) 和缺血性中风 (HR 0.873) 的发生率降低.
较少的重新干预 (升级),但在双室装置中发现了更多的血瘤和重新定位.

结论:

这些发现支持当前推的双腔心脏起器偏好在完整的AVB与鼻腔节律.
双室心脏起器植入与降低死亡,心力衰竭,心房动和中风风险有关.
双室节奏的好处超过了这种患者群体的潜在并发症.

关键词:

在心房房阻塞.心脏节拍是因为心脏节拍.

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