数字化疗法与ICD冲击传递和设备修改风险增加有关
Gerrit Frommeyer1, Philipp S Lange1, Thomas Kleemann2
1Clinic for Cardiology II - Electrophysiology, University of Münster, Münster, Germany.
概括
接受心脏植入式电子设备的静心性心力衰竭患者的Digitalis治疗与死亡率的增加无关. 然而,digitalis使用与更高的设备修改率和ICD冲击输送相关.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏衰竭管理的管理
背景情况:
- 迪吉塔利斯糖化物用于控制心房动率和治疗心力衰竭.
- 以前的研究表明,数字治疗可能会产生不良影响.
- 这项研究调查了在接受ICD或CRT-ICD植入的静心性心力衰竭患者中使用digitalis的情况.
研究的目的:
- 确定在接受心脏植入式电子设备的患者中使用数字治疗的流行率.
- 评估数字治疗对该患者群体临床结果的影响.
主要方法:
- 分析来自德国设备注册局 (German Device Registry) 的数据,这是一个全国性的前性注册局.
- 包括3826名接受ICD或CRT系统植入的患者.
- 将接受数字治疗的患者与没有接受数字治疗的患者之间的结局进行比较.
主要成果:
- 接受Digitalis治疗的患者有更严重的左心室功能障碍,更高的NYHA类,以及更多的左捆分支障碍.
- 一年死亡率和死亡,心肌梗塞或中风的复合终点在各组之间没有显著差异.
- 迪吉塔利斯治疗与增加ICD冲击传递和更高的设备修改风险有关.
结论:
- 在接受ICD或CRT植入的静心性心力衰竭患者中,Digitalis治疗与设备修改的风险增加有关.
- 没有观察到死亡率或主要心血管不良事件的显著差异.
- 在接受digitalis治疗的患者中,注意到ICD冲击发作的风险增加.
更多相关视频
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.2K
14:24Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
Published on: January 21, 2018
11.6K
相关概念视频
01:26Heart Failure Drugs: Inotropic Agents
451
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
451
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.1K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.1K
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
854
Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
854
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
676
Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
676
01:20Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
728
Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
728
01:30Pulse rhythm
734
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
734