根据心房隔膜缺陷关闭技术对心房失常和自主功能参数的比较
Akif Kavgacı1, Semiha Terlemez1, Sercan Tak2
1Department of Pediatric Cardiology, Faculty of Medicine, Gazi University, Ankara, Türkiye.
Frontiers in cardiovascular medicine
|February 11, 2026
概括
耳道隔膜缺陷的修复会增加心律失常的风险,特别是在手术后. 透导管关闭显示了与对照组相似的自主功能,与手术方法不同,这些手术方法减少了心率变化,增加了同情活动.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心脏电生理学 心脏电生理学
- 自主神经系统功能 自主神经系统功能
背景情况:
- 心房隔膜缺陷 (ASD) 增加了由于右心房扩张和电气重塑而导致心房失常的风险.
- 自主功能障碍也可以伴随ASD.
- 有限的比较数据存在于儿科患者的手术和透导管ASD关闭之间的心律失常风险.
研究的目的:
- 在手术后比较心律失常风险和自主功能与儿科患者中心房隔膜缺陷的跨导管关闭.
- 评估不同ASD关闭方法对心脏电生理学和自主平衡的长期影响.
主要方法:
- 对接受手术或透导管ASD关闭的儿科患者 (<18岁) 的回顾性分析,随访时间≥12个月.
- 包括一个年龄和性别相匹配的健康对照组.
- 使用12导电图和24小时霍尔特监测进行评估;排除患有其他心脏异常或相关药物的患者.
主要成果:
- 与对照组相比,在两个ASD闭合组中,心室上空早跳显著高于对照组,手术组的发病率最高 (p<0.001).
- 手术关闭后P波分散也最大.
- 手术关闭与显著减少的心率变化 (HRV) 和同情主导的指标有关.
结论:
- 前庭隔膜缺陷的修复,特别是手术干预,增加了心房律乱的风险.
- 过导管闭合导致自主功能与健康对照相比较.
- 手术关闭与HRV降低和交感活动增加有关,这表明自主调节发生了改变.
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