在心房动后的心室节律失常电动心脏转变:一个多中心研究
Oholi Tovia-Brodie1,2, Yoav Michowitz1,2, Feras Bayya1,2
1Department of Cardiology, Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel.
Heart rhythm O2
|December 9, 2024
概括
在心房动 (AF) 后的心室节律失常 (VAs) 电心转变 (ECV) 是罕见的 (0.2%),但可能致命,发生在72小时内. 密切监测心力衰竭和胆心不全的患者,特别是如果他们经历了ECV后的QT延长.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 临床医学 临床医学
背景情况:
- 心室节律失常 (VAs) 是心房动 (AF) 电动心脏转变 (ECV) 后的一个已知的并发症.
- 了解这些后ECVVA的发病率,时间和特征对于患者管理至关重要.
研究的目的:
- 为了确定AF ECV后发生的VA的发生率和时间.
- 描述ECV后出现VA的患者的临床特征.
- 为了确定与后ECV VAs相关的风险因素.
主要方法:
- 在13个中心进行了一项多中心观测回顾性研究.
- 包括在AFECV的10天内经历了VA或心脏突然死亡的患者.
- 排除了在ECV之前已经存在的VA患者.
主要成果:
- 在AF后的VAECV发生率为0.2% (在11,897项手术中23项).
- 在ECV发生后,VA的中位数为28.5小时,其中74%是Torsades de Pointes.
- 患者经常患有充血性心力衰竭 (74%),高血压 (74%),并服用QT延长药物 (74%). 经过心电梗塞后的胸心脏和QT延长也被发现.
结论:
- 在AF后的ECVVA很罕见,但可能是致命的,通常发生在3至72小时内.
- 建议对一小部分患者进行长期监测,特别是患有充血性心力衰竭的患者,服用III类抗不律性药物,并表现出后心电脉或QT延长.
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