在治疗恶性瘤的胸部照射期间和之后的心律不整
Markus B Heckmann1,2,3, Jan P Münster4, Daniel Finke4,5
1Department for Cardiology, Angiology, and Pneumology, Heidelberg University Hospital, Heidelberg, Germany. markus.heckmann@med.uni-heidelberg.de.
Cardio-oncology (London, England)
|November 15, 2024
概括
胸部放射治疗没有增加心脏植入式电气装置 (CIED) 的患者心脏节律失常事件. 患有先前心律失常的患者仍然面临更高的风险,需要个性化管理策略.
科学领域:
- 心脏病学 心脏病学
- 辐射瘤学 辐射瘤学
- 电子生理学 电子生理学
背景情况:
- 胸部放射治疗与心律失常并发症有关.
- 报道了布拉迪雅心律不整和动心律不整的情况.
- 对心脏植入式电器 (CIED) 患者的影响需要进行调查.
研究的目的:
- 分析患有CIED接受胸部照射的患者的心律失常负担.
- 检查放射治疗对CIEDs的直接和长期影响.
- 评估辐射治疗期间和之后的安全性和确定心律失常的危险因素.
主要方法:
- 对接受胸部放射治疗的CIED患者进行回顾性队列研究 (2012-2022年).
- 在放射治疗期间每日CIED监测和长期结果分析.
- 倾向性得分与长期随访的非辐射对照相匹配.
主要成果:
- 胸部辐射在治疗期间与心房失常有负面关联 (单变分析).
- 与对照组相比,在长期随访中没有观察到心律失常事件的显著增加.
- 以前的心律失常史是未来心律失常事件的最强有力的预测因素.
结论:
- 胸部放射治疗对于患有CIED的患者来说是安全的.
- 患有心律失常史的患者需要警监测和个性化管理.
- 需要进一步的研究来阐明胸部辐射的抗心律失常机制.
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