早期心房节点阻塞剂的影响 使用过导管后的大动脉置换
Jocelyn Edwards1, Zachary Carroll1, Mikayla Lovelace2
1University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
概括
在过导管大动脉置换 (TAVR) 后早期使用心房门 (AV) 节点阻塞剂并没有增加高度的AV阻塞或起器需求. 这些药物可以根据个人风险考虑在TAVR后使用.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 高度心房静脉阻塞 (AVB) 和永久起器 (PPM) 植入是通过导管的大动脉置换 (TAVR) 后的常见并发症.
- 有限的数据存在于早期TAVR后心房门 (AV) 节点阻塞剂的管理对这些结果的影响.
研究的目的:
- 评估在TAVR后48小时内使用AV结节阻塞剂的安全性.
- 确定早期AV节点阻塞剂使用与高度AVB和PPM放置的发生率之间的关联.
主要方法:
- 在756名接受TAVR的成年患者中进行了回顾性队列研究.
- 患者被分为两组:那些在48小时内接受AV结节阻塞剂的人和那些没有接受AV结节阻塞剂的人.
- 主要终点是手术后30天第二度或更高AVB的发生率.
主要成果:
- 在初级结局 (第二度或更高的AVB在30天) 中,两组之间没有显著差异 (1.6%对2.7%,p=0.297).
- 观察到类似的AVB发病率在出院时,PPM安置在30天后,以及住院时间长度.
- 最初在AV节点阻断剂组中观察到更高的30天全因死亡率,但在同变量调整后,这并不显著.
结论:
- 在TAVR后48小时内早期服用AV结节阻塞剂与高度AVB或PPM放置率的增加无关.
- 这些发现支持在TAVR后的立即时期考虑AV节点阻塞剂,以谨慎的风险效益评估为指导.
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