在婴儿期孤立的先天性完整心房阻塞中,双相对单腔心房节奏
Reina Bianca Tan1, Kristyn A Pierce1, James Nielsen1
1Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA.
JACC. Clinical electrophysiology
|February 28, 2025
概括
双室节奏 (DDD) 与单室节奏 (VVI) 相比,在患有先天性完全心房阻塞 (CCAVB) 的婴儿中增加左心室功能障碍的风险. 对于这些婴儿来说,建议使用单室节奏.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 电子生理学 电子生理学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 对于患有孤立先天性完全心房阻塞 (CCAVB) 的婴儿,心脏起器的最佳策略尚未确定.
- 双室节奏 (DDD) 提供了同步,但可能会增加心室节奏负担,可能导致左心室 (LV) 功能障碍.
研究的目的:
- 为了比较双腔 (DDD) 和单腔 (VVI) 节奏在CCAVB的婴儿之间的临床结果.
- 在这个人群中识别与不同节奏策略相关的风险.
主要方法:
- 一项多中心的回顾性研究 (2006-2023) 包括在1岁之前植入心脏起器的CCAVB婴儿.
- 排除标准包括显著的先天性心脏病和单位心室节奏.
- 评估的结果是临床显著的LV功能障碍,死亡率和与心脏起器相关的并发症.
主要成果:
- 在109名婴儿中 (60.6%的VVI节奏),10.1%的婴儿在中位数为5年的随访期间出现了临床显著的LV功能障碍.
- 与DDD节奏相比,LV功能障碍的发生率显著增加 (21%对3%,P=0.006).
- LV 功能障碍的独立风险因素包括 DDD 节奏和新生儿植入. 在较小的婴儿中,并发症更频繁.
结论:
- 双腔 (DDD) 节奏与与单腔 (VVI) 节奏相比,增加乳腺脏功能障碍的风险,与与单独的CCAVB相关.
- 对于需要节奏的孤立CCAVB的婴儿,应考虑使用单腔LV顶部节奏.
- 与节奏相关的并发症很常见,低体重新生儿的风险更高.
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