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编程电刺激诱导性与高伤性心肌病中的心律失常风险之间的关联:系统性审查和元分析
Adil Salihu1, Panagiotis Antiochos1, Henri Lu1
1Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
Heart (British Cardiac Society)
|April 16, 2025
概括
编程电刺激 (PES) 可以识别患有高伤心肌病 (HCM) 的患者,这些患者有重大心律失常事件 (MAE) 的高风险. 这项研究发现,PES诱导性与HCM患者的MAE风险增加10倍有关.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 遗传学 是一个遗传学.
背景情况:
- 突发心脏病死亡 (SCD) 风险分层在缩性心肌病 (HCM) 具有挑战性.
- 目前的指导方针不支持用于风险分层的编程电刺激 (PES).
- 在HCM中PES的预测价值仍在争论中.
研究的目的:
- 在HCM患者中,系统地审查和元分析PES诱导性和主要心律失常事件 (MAE) 之间的关联.
- 评估 PES 在 HCM 的 MAE 的预测值.
- 评估PES在HCM中SCD风险分层中的作用.
主要方法:
- 五项研究 (587名患者) 的系统综述和随机效应元分析.
- 在PubMed/MEDLINE,Embase和Cochrane图书馆搜索到2024年2月1日.
- 根据PES诱导性进行评估MAE (SCD,心脏骤停,ICD干预).
主要成果:
- 在32%的患者中发现了PES的诱导性.
- MAE发生在 18% 的可诱导患者中,而非可诱导患者中为 2%.
- 对于MAE,PES的诱导率显示为10.83 (95% CI 3.52至33.34) 的几率比.
结论:
- 在HCM患者中,PES的诱导性显著增加了MAE的风险,大约是10倍.
- 对于MAE,PES表现出高灵敏度 (81%) 和负预测值 (98%).
- 需要进一步的前性研究来确认PES在当代风险分层中的独立预测价值.
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