无心脏起器植入的有效性和安全性:一个单一中心的经验
Zhipeng Zhang1, Zonglei Wu1, Chao Luan1
1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Frontiers in cardiovascular medicine
|May 22, 2025
概括
无心脏起器 (LPs) 对八十岁患者来说是安全有效的,尽管伴随性疾病负担较高,但对年轻患者提供了相似的结果. 这项研究支持LP作为老年人传统的静脉输血起器的可行替代品.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 老年医学 老年医学
背景情况:
- 透静脉起器 (TVP) 在老年患者中具有显著的并发症率.
- 无心脏起器 (LPs) 提供了一个潜在的更安全的替代方案,并没有太多的并发症.
- 关于LP植入的数据有限,特别是在八十岁人群中.
研究的目的:
- 评估无心脏起器植入八十岁人的可行性和临床结果.
- 为了比较LPs的安全性和有效性,八十岁的人与非八十岁的人.
主要方法:
- 一组154名接受LP植入的患者被分为八十岁 (≥80岁) 和非八十岁 (<80岁) 患者.
- 评估了电气参数,程序特征和并发症率.
- 在平均12个月的随访期间,两组年龄组之间的结果进行了比较.
主要成果:
- 在所有患者中,LP植入是成功的,包括三名八十岁的患者,他们同时接受了心房节切除.
- 八基因组患者的并发症负担较高,但与非八基因组患者相比,其电气参数和手术持续时间相似.
- 虽然在统计学上不显著,但八十岁的患者患上周围手术并发症的发病率更高 (4.5%对1.1%) 并需要更多的部署尝试 (48.5%对26.1%).
结论:
- 无心脏起器植入是八十岁人群的安全和有效选择,即使是那些有重大并发症的人.
- 在老年人群中,LP应该被认为是传统的静脉输血起器的可行替代品.
- 经验丰富的中心可以通过LP植入八十岁的患者获得良好的结果.
相关概念视频
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...