新发病的左心室功能障碍在左子分支节奏之后
Shunmuga Sundaram Ponnusamy1, Vithiya Ganesan2, Sudharshana Nagalingam3
1Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India.
JACC. Clinical electrophysiology
|September 28, 2024
概括
新发病的左心室功能障碍 (NOLVD) 在左束枝节奏 (LBBP) 后发生在3.75%的患者中. 大多数病例是由于可逆原因造成的,例如传导系统捕获的损失,强调需要定期监测设备.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 这是心脏衰竭.
背景情况:
- 左捆枝节奏 (LBBP) 是一种提供稳定的参数的节奏技术,被认为是传统右心室节奏的替代品.
- 此外,LBBP还被探索为心力衰竭患者的心脏再同步治疗的方法.
研究的目的:
- 为了确定LBBP后新出现的左心室功能障碍 (NOLVD) 的发生率和原因.
- 在最初正常的左心室 (LV) 功能和以前受损但正常化的LV功能患者中调查NOLVD.
主要方法:
- 分析了426名患者的队列,这些患者接受了成功的LBBP治疗,以诊断症状性胸腺节律不良或CRT.
- 患者被分为基线正常的LV功能和LBBP后正常化的LV功能.
- 传导系统捕获的损失 (LOCSC) 被定义为在值测试期间失去右束分支块模式和捕获过渡.
主要成果:
- 新发病的左心室功能障碍 (NOLVD) 在3.75%的患者 (426例中16例) 中观察到.
- 在62.5%的病例中,NOLVD的主要原因是传导系统捕获损失 (LOCSC).
- 重新干预,包括重定位和AV延迟优化,在所有受影响的患者中成功恢复了LV功能.
结论:
- 新发病的左心室功能障碍 (NOLVD) 可以发生在左束枝节奏 (LBBP) 后,即使在以前正常或恢复的LV功能的患者中.
- 可逆原因,特别是传导系统捕获损失 (LOCSC),是NOLVD的重要贡献者.
- 在设备诊所进行定期的后续评估对于在LBBP后早期发现和管理NOLVD至关重要.
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