布鲁加达综合征的植入式心脏转换器-除器治疗:一个30年的单中心经验
Cinzia Monaco1, Maria Cespon-Fernandez1, Luigi Pannone1
1Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks, Guard-Heart, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium.
JACC. Clinical electrophysiology
|March 15, 2025
概括
植入式心脏转换器-除器 (ICD) 对于预防布鲁加达综合征患者突然心脏死亡至关重要. 胸腔镜上心膜切除提供了一个有前途的辅助疗法,在高危人群中减少心室节律失常.
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:
- 布鲁加达综合征 (BrS) 仍然是一个临床挑战,尽管几十年的研究.
- 植入式心脏转换器-除器 (ICD) 对于预防高风险BrS患者的突然心脏死亡至关重要.
- 关于风险分层和初级预防ICD在BrS中的使用存在持续的辩论.
研究的目的:
- 评估布鲁加达综合征患者的ICD治疗的临床特征,管理和长期结果.
- 评估ICD在预防心室节律失常和心脏突然死亡方面的有效性.
- 为了研究表心除作为高风险BrS患者的辅助疗法的作用.
主要方法:
- 有布鲁加达1型心电图图案的BrS患者的未来招募.
- 在三十年 (1992-2022) 的时间里,对ICD植入策略和患者随访的分析.
- 使用先前心律失常事件和布鲁塞尔风险评分进行风险分层;对高风险患者进行视频胸腔镜上心膜切除.
主要成果:
- 306名BrS患者接受了ICD;16%用于二次预防.
- 长期随访显示,14%的患者经历了持续的心室节律失常,15%的患者有不适当的ICD冲击.
- 在高风险患者中,心上膜切除显著减少了心室事件;整体死亡率为5.88%.
结论:
- ICD治疗对于预防布鲁加达综合征中致命性心律失常至关重要.
- 与设备相关的并发症很常见,特别是在年轻的患者中.
- 胸腔镜上心膜切除是高风险BrS患者的有前途的辅助疗法,改善了长期的结果.
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