在双心室心脏再同步治疗中,心室速率调节节奏的不良影响
Chu-Pak Lau1, Kathy Lai-Fun Lee1, Hung-Fat Tse1,2,3
1Cardiology Division, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
Journal of cardiovascular electrophysiology
|September 18, 2025
概括
心室速率调节 (VRR) 可以不适当地增加CRT-D患者的节奏率,这些患者经常出现早发性心室收缩 (PVC),可能会恶化心力衰竭. 在一个案例研究中,禁用VRR的正常化节奏率.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心脏衰竭管理的管理
背景情况:
- 像心室节奏调节 (VRR) 这样的心室节奏策略旨在改善双心室节奏,并预防由早发性心室收缩 (PVC) 引发的心室动脉障碍 (VTs).
- 在频繁的PVC中,VRR可能导致不适当的速率增加,从而加剧CRT-D患者的心力衰竭的可能性仍然未得到报道.
研究的目的:
- 调查VRR对CRT-D设备常见PVC的患者节拍率和心力衰竭状态的影响.
- 要突出VRR在特定患者群体中不适当加速速度的风险.
主要方法:
- 一名72岁的男性患有扩张性心肌病和心房动,接受了CRT-D治疗后的病例报告.
- 观察持续高的双心脏 (BV) 节奏率和VRR在频繁的PVC和不持续的VT期间的影响.
- 干预涉及抗心律失常药物和随后的VRR无活化.
主要成果:
- 患者出现心力衰竭和持续的BV节奏率超过100 bpm.
- 频繁的PVC和不持续的VT导致了由于VRR而持续的高节奏率.
- 用抗失常药物部分实现了速率正常化,并在VRR失活后完全恢复.
结论:
- 心室速率调节 (VRR) 可能是患有CRT-D和频繁PVC的患者不适当的节奏速率增加的一个重要因素.
- 应该仔细考虑VRR作为潜在的贡献者恶化心力衰竭在这个患者群体.
相关概念视频
Disturbances in Heart Rhythm
2.6K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
2.6K
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
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
1.6K
Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
1.6K
Decreased pulse rate
843
Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...
843
Mechanism of Cardiac Arrhythmias
1.7K
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
1.7K
Dysrhythmias III: Characteristics of Dysrhythmias
422
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
422


