连续流动左心室辅助器件接受者的心室节律失常的发生率,预测因素和结果:多中心分析
Jobin Varghese1, Jashan Gill1, Rezwan Munshi1
1MercyOne North Iowa Medical Center, Mason City, Iowa, USA.
Journal of cardiovascular electrophysiology
|August 1, 2025
概括
在左心室辅助器 (LVAD) 患者中,先前存在的心室节律失常 (VAs) 会增加植入后心律失常事件和住院治疗. 然而,以前的VA病史不会影响长期生存,而LVEDD是关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 节律失常学 节律失常学
背景情况:
- 在使用左心室辅助器件 (LVAD) 的患者中,心室节律失常 (VAs) 是常见的.
- 在LVAD接受者中,VA的预后意义尚未得到充分确立,之前的研究显示了相互矛盾的结果.
- 这项研究调查了大型LVAD队列中VA的发病率和临床影响.
研究的目的:
- 确定先前存在的VA和LVAD后的临床结果之间的关联.
- 评估VA对LVAD患者的生存,住院和设备治疗的影响.
- 为了确定具有VA史的LVAD接受者死亡率的预测因子.
主要方法:
- 在五个中心 (2007-2015) 进行LVAD植入的408名患者的分析.
- VA定义为持续的VA (>30s) 或需要ICD治疗.
- 评估LVAD前后对生存,住院和ICD冲击的影响.
主要成果:
- 62%的患者有LVAD前的VA病史.
- 在LVAD前的VA患者出现了更高的植入后VA率 (73%对37%),心房失常,ICD冲击和心脏住院.
- 两组之间没有观察到总死亡率的显著差异;LVEDD是死亡率的唯一独立预测因素.
结论:
- 前LVADVA与植入后心律失常负担和发病率的增加有关,但与长期死亡率无关.
- 左心室终端透气维度 (LVEDD) 是比心律失常史更重要的生存决定因素.
- 个性化心律失常监测和管理对于LVAD患者具有先前的VAS至关重要.
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