在预计需要频繁的心室节拍 (BioPace) 的患者中,双心室与右心室节拍装置对比
Reinhard C Funck1, Hans-Helge Müller2, Maurizio Lunati3
1Klinik für Innere Medizin - Kardiologie, Philipps-Universität Marburg, Baldingerstr, Marburg 35033, Germany.
概括
在患有保留喷射分数和狭窄QRS的患者中,双心室节奏并没有证明优于右心室节奏. 对这个患者群体来说,右心室节奏可能比以前认为的不那么有害.
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:
- 右心室 (RV) 节奏可能导致左心室 (LV) 功能障碍.
- 有限的证据表明,双心室 (BiV) 节奏比RV节奏在患有保留LV射出分数 (LVEF),狭窄QRS和高心室节奏负担 (HVPB) 的患者中有好处.
研究的目的:
- 为了评估BiV节奏是否与VR节奏相比,在患有保存LVEF,狭窄QRS和预期HVPB的患者中改善了临床结果.
主要方法:
- 对心房阻塞预防心脏脱同步 (BioPace) 试验的双管节律调节是一个多中心,单盲,随机的研究.
- 1810名患者被随机分配到BiV节拍 (n=902) 或RV节拍 (n=908).
- 同主终点包括死亡时间或第一次心力衰竭住院时间和生存时间,平均随访时间为68.8个月.
主要成果:
- 在BiV和RV节奏组之间,死亡或心力衰竭住院的复合终点没有显著差异 (HR 0.878;P = 0.0882).
- 这两组的死亡率相似 (HR 0.926;P = 0.3492).
- 观察到的初级终点差异小于20%.
结论:
- 在患有保存LVEF,狭窄QRS和HVPB的患者中,双管管节律调节没有显示出优于RV节律调节的优势.
- 对于这些患者来说,RV节奏可能比通常认为的不那么有害.
- 主要BiV节奏测定对这一特定患者群体没有明显的临床结果优势.
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