器件引线异常和功能,经过跨导管三管替换后的功能.
Muhannad Abbasi1, Ammar M Killu1, Christoff Van Niekerk2
1Department of Cardiovascular Medicine, Mayo Clinic Rochester, 200 1st ST SW, Rochester, MN 55902, USA.
概括
透导管三门置换 (TTVR) 可以影响心脏植入式电子设备 (CIED) 导致31%的患者. 大多数变化是轻微的,并保守地管理,但有些需要干预.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 跨导管三管替换 (TTVR) 越来越多地用于严重的三管吐.
- 接受TTVR治疗的患者往往已经有心脏植入式电子设备 (CIED).
- 对于TTVR对CIED完整性和功能的影响仍然不完全理解.
研究的目的:
- 为了评估TTVR使用EVOQUE门系统对CIED领先功能的影响.
- 评估TTVR后节奏值,传感和阻抗的变化.
- 在TTVR期间识别与CIED相关的潜在并发症.
主要方法:
- 在梅奥诊所罗切斯特进行了回顾性观察性研究.
- 包括32名连续患有先前存在的CIED的患者,他们使用EVOQUE系统进行了TTVR.
- 在TTVR之前和之后分析CIED领先参数 (速度值,传感,阻抗).
主要成果:
- 31%的患者 (10/32) 在TTVR后经历了功能变化.
- 右心室导管最常受到影响.
- 感应R波变化是最常见的变化 (55%的受影响病例),通常是孤立的,并保守地管理.
- 13%的患者 (4/32) 显示有关绝缘断裂的发现,其中一个需要进行修改.
- 两名患者 (40%的随访时间>600天) 呈现逐渐阻抗下降,这表明潜在的亚临床降解.
结论:
- 使用EVOQUE系统的TTVR与31%的CIED患者的功能变化有关.
- 大多数与有关的变化是可以保守地管理的,但由于隔热破坏的担忧,一个子集需要干预.
- 需要进一步的研究,以优化在TTVR期间对设备-相互作用的植入技术和管理策略.
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