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节律失常的类型和频率 状态 在6岁后的混合程序后
Garrett Muckleroy1, Phillip Cheng2, Isaac Kistler2
1Heart Center, Nationwide Children's Hospital, Columbus, OH, 43205, USA. garrett.muckleroy@nationwidechildrens.org.
Pediatric cardiology
|August 1, 2025
概括
对于单心室缺陷进行混合途径的患者在Fontan手术后会常见,大多是良性心律失常. 与单心室重建试验相比,心房律不整的频率更高,但心室律不整和起器需求相似.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
- 电子生理学 电子生理学
背景情况:
- 混合途径为低可塑性左心综合征 (HLHS) 和单心室阻塞生理学提供了替代性的手术方法.
- 有限的数据存在于经过混合途径的患者在Fontan后心律失常的发生率和类型.
研究的目的:
- 为了评估混合途径治疗的患者在Fontan手术后心律失常的频率和类型.
- 将混合途径组中的Fontan后心律失常率与单心室重建试验 (SVRT) 的历史数据进行比较.
主要方法:
- 对单心室解剖学患者的回顾性图表审查,这些患者完成了混合手术和Fontan手术.
- 分析Fontan前心电图,6年后的Fontan心电图和Holter监测以及心脏药物数据.
- 混合途径组与SVRT Norwood-shunt和Norwood-conduit组之间的心律失常发病率的比较.
主要成果:
- 在69%的霍尔特患者中发生了心房失常,在62%的患者中发生了心室失常,主要是孤立和罕见的.
- 混合途径组与SVRT组相比,心房律乱的几率更高 (OR 4.11-4.38).
- 室腔失常和心脏起器发病率在各组中相似;混合途径的AV阻塞几率低于诺伍德导管 (OR 0.35).
结论:
- 在Fontan后6年,良性心房和心室节律失常在混合途径患者中很常见.
- 虽然心房律乱在混合组中更频繁,但整体心律乱概况和对心脏起器的需求与SVRT数据相似.
- 建议对这种高风险人群进行持续监测,以有效管理Fontan后心律失常.
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