在患有心房动的患者中,步伐和减速策略的长期结果
Johan van Koll1, Madelon D E A Engels1,2, Jesse H J Rijks1
1Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.
概括
对心房动 (AF) 的节奏和减缓策略显示高死亡率和心力衰竭住院率. 然而,心脏再同步疗法 (CRT) 改善了左心室喷射率 (LVEF) 减少LVEF的患者.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏衰竭管理的管理
背景情况:
- 节奏和减缓策略是对其他治疗不耐药的症状持续性心房 (AF) 的二线治疗.
- 评估AF患者的节奏和减缓策略的长期临床结果对于治疗优化至关重要.
研究的目的:
- 评估持续症状性心房动 (AF) 患者的节奏和消耗策略的长期临床结果.
- 为了比较右心室节奏 (RVP) 和心脏再同步治疗 (CRT) 之间的结果,作为节奏和减缓策略的一部分.
主要方法:
- 在2010年至2020年期间,对接受心脏起器植入 (RVP或CRT) 之后进行心房结节切除 (AVNA) 的患者进行回顾性分析.
- 主要终点:综合所有原因死亡率和心力衰竭住院治疗 (HFH).
- 二级终点:全因死亡率,高血压和左心室喷射率 (LVEF) 的变化.
主要成果:
- 主要终点发生在RVP组的47%和CRT组的49% (p=0.206).
- 在CRT组 (45%) 的全因死亡率高于RVP组 (36%) (p=0.005).
- 在CRT组中,LVEF显著改善 (31%至43%,p<0.001),但在RVP组中保持稳定 (56%至53%,p=0.081).
结论:
- 节奏和减缓策略与AF患者的高死亡率和心力衰竭住院治疗有关.
- 心脏再同步疗法 (CRT) 有效地改善了先前存在的减少LVEF的患者的LVEF.
- 需要CRT升级的LVEF恶化在RVP患者中不常见,在AVNA之前基线LVEF正常.
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