插入式心脏监视器检测到心房的影响,对未来的缺血事件,以后的密码性中风
Ronak Bharucha1, Jitae Kim1, Mohammad Alsheikh-Kassim1
1Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
JACC. Advances
|January 21, 2026
概括
可插入的心脏监测器在密码性中风 (CS) 后检测到心房动 (AF),但这些患者中大多数复发性中风可能与AF无关. 需要进一步的试验来确认常规ICM植入用于二次CS预防的好处.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗器械 医疗器械
背景情况:
- 插入式心脏监测器 (ICM) 在加密性中风 (CS) 后被用于检测心房动 (AF) 和指导治疗.
- 植入ICM对CS患者中风复发的影响尚未得到充分证实.
研究的目的:
- 为了比较中风复发率在CS患者和没有ICM检测到的AF.
- 在这个群体中确定复发性中风的预测因子.
主要方法:
- 追溯分析840名患有CS或过渡性缺血性发作的患者,这些患者接受了ICM.
- 随访时间的中位数为990天.
主要成果:
- 在235名患者 (27.9%) 中检测到心房动 (AF).
- 复发性中风发生在112名患者中;其中70.5%发生在没有检测到AF的患者中.
- 检测到的AF患者的中风复发率增加 (调整HR:2.73),与CHA2DS2-VASc得分≥4和男性性别的患者一样.
结论:
- 尽管ICM在很大一部分CS患者中检测到AF,但大多数复发性中风可能来自其他原因.
- 常规使用ICM用于二次CS预防需要通过随机试验进行进一步调查.
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