引入一种新的心脏起器介导的节律失常:由心房捕获挑战产生的伪RNRVAS
1Ankara Bilkent City Hospital, Ankara, Turkey.
概括
由于心房捕获损失,出现了一种新型的节律失常,即伪重复性非再入的VA同步 (伪RNRVAS). 这种情况可能发生在心率低的情况下,可能与起器综合征有关.
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:
- 一种新的心脏起器媒介性心律失常,伪重复性非反入性VA同步 (伪RNRVAS),是由心房捕获损失和心室内心室 (VA) 导电在心室后心房阻断期 (PVARP) 内启动的.
- 与RNRVAS不同,伪RNRVAS涉及心房下感应,而不是心房折射性.
研究的目的:
- 定义和解释伪RNRVAS的机制.
- 为了确定导致患者患上这种心律失常的因素.
- 提出预防伪RNRVAS的策略.
主要方法:
- 在PVARP中招募了21名具有双腔植入式电子设备和稳定的VA导电的患者.
- 通过调整心房节拍幅度和较低的节拍间隔来诱导伪RNRVAS.
主要成果:
- 伪RNRVAS在21名患者中20名患者中发生在心房捕获损失后.
- 这种心律失常发生在11名患者的低心率 (≤70bpm) 和7名患者的短AV延迟 (≤150ms) 时.
- 在18名患者中,在第一个心室节拍后立即启动的伪RNRVAS击败了心房捕获后的损失;它在14名患者中持续存在.
结论:
- 伪RNRVAS可以在没有RNRVAS典型的特定易感因子的情况下发生,即使心率低.
- 增加心房节奏概率和值会增加伪RNRVAS的风险.
- 早期植入后和起器综合征可能会增加对这种心律失常和心力衰竭的易感性.
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