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无和透静脉心脏起器植入后的节奏诱导心肌病:一个多中心的回顾性研究
Kevin Lee1, Mashaal Ikram1, Madhu Reddy2
1Department of Cardiology, Endeavor Health, Cardiovascular Institute, Glenview, Illinois.
Heart rhythm O2
|January 16, 2026
概括
在无心脏起器 (LP) 和输静脉起器 (TVP) 之间,节奏诱导心肌病 (PICM) 的发生率相似. 长时间的节奏QRS预测PICM,而更高的基线LVEF提供了保护.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电子生理学 电子生理学
背景情况:
- 节奏诱导心肌病 (PICM) 是一种已知的并发症,与静脉穿起器 (TVP) 相关.
- 新出现的数据表明,使用无心脏起器 (LP) 的PICM率可能更低.
- 这项研究旨在比较LP和TVP队列之间的PICM发生率并确定LP和TVP队列之间的风险因素.
研究的目的:
- 确定和比较无心脏起器 (LP) 和透静脉起器 (TVP) 之间的节奏诱导心肌病变症 (PICM) 的发生率.
- 在接受LP或TVP的患者中确定与PICM发展相关的潜在风险因素.
主要方法:
- 一项多中心回顾性研究包括176名LP (Micra) 患者和522名TVP患者.
- PICM被定义为左心室喷射率 (LVEF) 从≥50%降至≤40%的下降,心室节奏≥20%.
- 用物流回归分析来确定PICM的预测因素.
主要成果:
- PICM发生在6.3%的LP接受者和7.9%的TVP接受者中,没有统计学上显著的差异 (OR:0.78,95%CI:0.39-1.56,P = .480).
- 多变量分析确定了延长的节奏QRS持续时间作为PICM的显著预测因素 (OR 1.02 [1.00-1.03],P = .009).
- 较高的植入前LVEF被发现可以防止PICM的发展 (OR 0.92 [0.88-0.97],P = .001).
结论:
- 在无和透静脉心脏起器植入之间,节奏诱导心肌病率是可比的.
- 长时间的节奏QRS持续时间是开发PICM的关键预测因素.
- 较高的基线左心室喷射分数作为PICM的保护因素.
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