在左心室辅助装置植入后,长期植入式心脏转换器除器导致功能障碍
Tsukasa Oshima1, Kohei Ishibashi1, Kenichiro Yamagata2
1Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
JACC. Advances
|October 25, 2025
概括
在左心室辅助装置植入后,植入式心脏转换器除器功能障碍很常见,大多数病例持续长期. 植入后两个月出现的功能障碍是持续问题的关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏衰竭管理的管理
背景情况:
- 植入式心动除器 (ICD) 功能障碍是左心室辅助装置 (LVAD) 植入后已知的并发症.
- 以前的研究主要集中在这种并发症的短期结果上.
研究的目的:
- 评估LVAD植入后ICD功能障碍的长期发生率.
- 描述功能障碍的性质 (持续性与暂时性).
- 为了确定LVAD植入后持续性ICD功能障碍的预测因素.
主要方法:
- 追溯多中心研究.
- 在LVAD植入时 (2011-2023年) 纳入透静脉ICD患者.
- 后勤分析以确定持续性与临时性功能障碍的风险因素.
主要成果:
- 在170名患者中,功能障碍发生在72.9%的患者中,平均随访时间为46.2个月.
- 持续性功能障碍占124个主要功能障碍事件的67.7%.
- 在LVAD植入后2.1个月后发生的功能障碍是持续功能障碍的独立风险因素 (OR:4.67).
结论:
- ICD功能障碍非常普遍,在LVAD植入后经常持久.
- 晚期发病的功能障碍 (LVAD后2个月以上) 是持续性功能障碍的重要预测因素.
- 这些发现强调需要对LVAD患者的ICD线索进行警监测.
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