逐步步进的QRS扩大:用于预测心脏再同步治疗升级的电心图标记
Takayuki Shimizu1, Keijiro Nakamura1, Naohiko Nemoto2
1Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Meguro-Ku, Japan.
Pacing and clinical electrophysiology : PACE
|September 17, 2025
概括
节奏QRS持续时间的逐渐扩大 (pQRSd) 预测需要对心脏再同步治疗 (CRT) 升级,在患有右心室节奏的患者中. 监测pQRSd趋势有助于早期识别可能受益于CRT的患者.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 慢性右心室 (RV) 节奏会导致左心室功能障碍.
- 这种功能障碍可能需要心脏再同步治疗 (CRT) 的升级.
研究的目的:
- 评估节奏QRS持续时间 (pQRSd) 和其进展是否预测需要CRT升级.
- 通过pQRSd监测识别CRT升级高风险患者.
主要方法:
- 对410名依赖VR节奏的患者 (2017-2022) 的回顾性分析.
- 在心脏起器植入后和潜在的CRT升级之前分析pQRSd.
- 计算 ΔpQRSd (pQRSd 的变化).
主要成果:
- 51名患者 (12.4%) 接受了CRT升级.
- 与年龄相关的CRT升级,升级前的pQRSd和基线LVEF.
- 在CRT升级患者 (16毫秒对0.6毫秒) 中,ΔpQRSd显著更大.
- 使用ROC分析确定了pQRSd和ΔpQRSd的最佳截止值.
结论:
- 逐渐扩大pQRSd是一个新的标志物,用于识别需要CRT升级的患者.
- 对pQRSd趋势的常规心电图监测可以早期识别CRT候选者.
- 这一策略可以帮助预防RV节奏患者的晚期心力衰竭.
更多相关视频
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
10.9K
08:05Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice
Published on: June 29, 2022
3.4K
相关概念视频
Electrocardiogram
5.4K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
5.4K
Correlation between ECG and Cardiac Cycle
11.7K
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
11.7K
Pulse rhythm
1.3K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.3K
Dysrhythmias IV: Characteristics of Bradyarrhythmias
500
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
500
Cardiac Action Potential
5.8K
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
5.8K
Dysrhythmias V: Evaluating Dysrhythmias
331
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
331
