在患有持续性或长期持续性心房的患者中,失败的电动心脏转换的危险因素
Donghwan Ku1, Hong Euy Lim2, Jino Park1
1Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Acta cardiologica
|January 6, 2026
概括
在心房动 (AF) 中,识别失败电心转变 (ECV) 的危险因素至关重要. 更长的AF持续时间,心力衰竭史和增加的左心房体积指数预测ECV失败.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 内部医学 内部医学
背景情况:
- 电动心脏转换 (ECV) 是一种持续性或长期持续性心房动 (AF) 的节律控制策略.
- 识别ECV失败的预测因素可以优化患者选择,改善治疗结果.
研究的目的:
- 在患有持续性或长期持续性AF的患者中,确定与失败的ECV相关的临床风险因素.
- 引导选择那些更有可能从节律控制策略中受益的患者.
主要方法:
- 对1058名接受ECV治疗的患者进行了回顾性审查,以治疗持久或长期持久的AF.
- 患者被分为三组:成功维持SR>1年,成功维持SR≤1年,并失败ECV.
- 临床特征的分析,包括AF持续时间,并发症和左心房 (LA) 尺寸.
主要成果:
- 失败的ECV (8%的患者) 与更长的AF持续时间,女性性别,冠状动脉疾病 (CAD) 和心力衰竭 (HF) 的病史以及增加LA直径和体积指数 (LAVI) 相关.
- 单变分析确定了AF持续时间 (≥50个月),女性性别,CAD,HF,增加LA直径 (≥45毫米),增加LAVI (≥45毫升/米2),以及缺乏抗失常药的使用作为风险因素.
- 多变量分析强调了AF持续时间 (≥50个月),HF病史和增加的LAVI作为失败ECV的显著预测因素.
结论:
- 较长的AF持续时间,心力衰竭史和左心房体积指数增加是持续性或长期持续性AF中失败的电心转变的强有力的预测因素.
- 这些因素可以帮助临床医生为AF患者选择适当的节律控制策略.
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