持久性心房动与左心房低压区域:谁可以从额外的修改中获益?
Hengzhi Zhang1, Ning Chen1, Qiuheng Bian1
1Division of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Guangzhou Road, Nanjing, 210029, China.
概括
额外的低压区域 (LVA) 切除可能会改善老年患者经历持续性心房动 (PeAF) 切除的结果. 这一策略对65岁及以上的PeAF患者特别有益.
科学领域:
- 电子生理学 电子生理学
- 心脏病学 心脏病学
- 医疗器械 医疗器械
背景情况:
- 低压区域 (LVAs) 与持续性心房动 (PeAF) 移除后更高的复发率相关.
- 在PeAF治疗中,额外的LVA修改的有效性仍在争论中.
研究的目的:
- 调查影响PeAF患者补充LVA切除的益处的因素.
- 分析年龄和LVA负担对STABLE-SR-II试验中废除结果的影响.
主要方法:
- 关于STABLE-SR-II试验的子研究,该试验涉及患有LVAs的PeAF患者.
- 随机分配到单独的环周肺静脉隔离 (CPVI) 或CPVI加LVA切除.
- 主要结局:18个月后没有心房节律失常.
主要成果:
- 在48%的PeAF患者中发现了LVAs.
- 额外的LVA废除在65岁以上的患者 (HR 0.14) 和LVA负担≥15% (HR 0.01) 的患者中显示出显著的益处.
- 年龄较大的患者 (≥65岁) 无论LVA负担如何,都显示LVA切除的益处最为显著.
结论:
- 在CPVI之后的LVA切除可能在初始程序期间为老年PeAF患者 (≥65岁) 提供额外的好处.
- 这种方法可以完善针对特定PeAF患者亚组的消化策略.
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