在CIED患者中,P波持续时间,分散和心房间间隔阻塞和心房高频发作之间的关联
Phuuwadith Wattanachayakul1,2, Adivitch Sripusanapan3, Narathorn Kulthamrongsri4
1Department of Medicine, Jefferson Einstein Hospital, Philadelphia, Pennsylvania, USA.
Pacing and clinical electrophysiology : PACE
|October 5, 2024
概括
高心房发作率 (AHRE) 与更糟糕的结局有关. 这项研究发现,较长的P波持续时间和P波分散,以及心腔间阻塞,预测心脏植入式电子设备患者的AHRE发展.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 心房高频发作 (AHRE) 与心脏植入式电子设备 (CIED) 患者的血栓栓塞风险和死亡率增加有关.
- 识别AHRE的预测因子对于监测和及时干预至关重要,可能会防止进展为临床心房动 (AF).
- 对于AHRE发展的P波特征的预测价值需要进一步澄清.
研究的目的:
- 进行一项元分析,调查基线P波特征 (P波持续时间,P波分散,心间阻塞) 与发展AHRE的风险之间的关联.
- 总结现有证据,关于在CIED患者中P波异常对AHRE的预测值.
主要方法:
- 在MEDLINE和EMBASE数据库中进行了系统的文献搜索,直到2024年5月.
- 进行了九项研究的元分析,将P波持续时间 (PWD) 和P波分散 (PWDIS) 的数据汇集在一起,使用平均差异 (MD).
- 用风险比率 (RR) 和通用逆方差方法评估了心房间间隔阻塞 (IAB) 和AHRE风险之间的关联.
主要成果:
- 与没有AHRE的患者相比,患有AHRE的患者表现出明显更长的PWD (MD: 9.17 ms; 95%CI: 4.74-13.60) 和PWDIS (MD: 20.56 ms; 95%CI: 11.57-29.56).
- 间阻塞 (IAB) 与发展AHRE的风险大大增加有关 (RR: 3.33; 95% CI: 2.53-4.38).
- 所有汇总的估计结果都显示出统计学意义 (p < 0.001),PWD和PWDIS的异质性适度.
结论:
- 增加的P波持续时间和P波分散是CIED患者AHRE发展的显著预测因素.
- 间阻塞与发展AHRE的风险增加密切相关.
- 这些P波异常值得考虑风险分层和CIED患者的加强监测.
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