在患有先前存在的右束分支阻塞的患者中,心脏起器植入后跨导管大动脉置换的发生率和预测因素
Rahul Prabhu1, Karan Rao2, Jonathan L Ciofani3
1Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
The Canadian journal of cardiology
|February 7, 2026
概括
患有先前存在的右捆支部阻塞 (RBBB) 的患者接受过导管大动脉植入 (TAVI) 具有永久起器植入 (PPI) 的高率. 确定RBBB特定的预测因子对于改善高风险组的风险分层和程序规划至关重要.
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:
- 预先存在的右捆分支阻塞 (RBBB) 是通过导管的大动脉植入 (TAVI) 后永久起器植入 (PPI) 的重要预测因素.
- 由于其高风险概况,了解TAVI患者的PPI预测因子对于RBBB患者至关重要.
- 本综述侧重于PPI发病率和预测因素,特别是在接受TAVI的RBBB子组内.
研究的目的:
- 为了评估永久心脏起器植入 (PPI) 的发生率,在接受过导管大动脉植入 (TAVI) 的患者中,先前存在的右束分支阻塞 (RBBB).
- 在这个特定的高风险队列中确定PPI的人口统计学,解剖学,电生理学和程序预测因素.
- 为RBBB的TAVI患者提供个性化的程序规划和风险分层信息.
主要方法:
- 主要科学数据库 (PubMed,Scopus,Embase,Web of Science) 的系统审查.
- 包括在接受TAVI的RBBB患者中报告PPI发生率和预测因子的研究.
- 聚合PPI发病率计算和识别的预测因素的定性叙事综合.
主要成果:
- 对22项涉及429342名患者的研究的分析显示,在RBBB队列中,PPI的综合发病率为37% (39%在持续30天随访的研究中).
- RBBB队列包括年长的男性,其中心房的流行率显著.
- 识别的PPI预测因素跨越了人口统计学,解剖学,电生理学和程序因素.
结论:
- 患有基线RBBB的患者在TAVI后经历了显著更高的PPI比率.
- 传统因素 (例如植入深度) 和非传统因素 (例如女性性别,心肌纤维化,特性) 在预测PPI风险方面发挥着至关重要的作用.
- 需要进一步的研究来完善风险分层,并减少TAVI患者与RBBB的PPI发生率.
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