التفاصيل البيبلوغرافية
| العنوان: |
左束支起搏在持续性心房颤动伴慢心室率 患者中的临床疗效. (Chinese) |
| Alternate Title: |
Clinical efficacy of left bundle branch pacing in patients with persistent atrial fibrillation complicating slow ventricular rate. (English) |
| المؤلفون: |
张宇航, 王岳松, 杨达, 董学滨, 邵旭武, 王学忠 |
| المصدر: |
Journal of Practical Electrocardiology; Feb2024, Vol. 33 Issue 1, p44-48, 5p |
| Abstract (English): |
Objective To observe the clinical efficacy and safety of left bundle branch pacing ( LBBP) in patients with persistent atrial fibrillation ( PAF) complicating slow ventricular rate. Methods Fifty-six patients who had undergone pacing treatment due to PAF complicating slow ventricular rate were selected. The patients were divided into right ventricular septal pacing (RVSP) group (29 cases) and LBBP group (27 cases) based on the implantation site of ventricular pacing electrode. Each group was further divided into heart failure (HF) and non-HF subgroups according to clinical symptoms and related examination results. The changes of pacing parameters (such as threshold, perception and impedance ), ECG, echocardiography, and plasma pro-brain natriuretic peptide (NT-proBNP) were observed during operation and 12 months after operation. Other conditions including pacing related complications, re-hospitalization due to HF, newly emerging cerebral infarction and all-cause death were also observed. Results (ⅰ) There is no statistically significant difference in pacing parameters between the two groups (P>0. 05). The NT-proBNP level of HF patients in both subgroups decreases 12 months after surgery compared with that before, however its reduction in the HF subgroup of the RVSP group is not significant (P> 0. 05). (ⅱ) In the RVSP group, there is no significant difference in LVEF or LVDd 12 months after surgery compared with that before ( P > 0. 05); LAD significantly increases ( P < 0. 05) while mitral regurgitation is obviously worsened (P<0. 05). In the LBBP group, there is no significant change in LAD or mitral regurgitation 12 months after surgery compared with that before (P>0. 05); LVEF increases while LVDd decreases in those with HF 12 months after surgery (P < 0. 05). (ⅲ) Compared with that before operation, QRS complex duration is prolonged in both groups (P<0. 05), and its value in the RVSP group is significantly greater than that in the LBBP group (P<0. 05). (ⅳ) There is no significant difference in pacing related complications or cardiovascular and cerebrovascular events between the two groups (P>0. 05); the re-hospitalization rate in the RVSP group is higher than that in the LBBP group (P<0. 05).Conclusion Among patients with PAF complicated by slow ventricular rate, LBBP helps to delay or reverse left ventricular remodeling of those with HF, improve cardiac function, and reduce readmission rate due to HF. LBBP should be recommended as the preferred pacing treatment method for atrial fibrillation patients with slow ventricular rate. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): |
目的 观察左束支起搏(left bundle branch pacing, LBBP)治疗持续性心房颤动(简称 房颤)合并慢心室率患者的临床有效性和安全性。 方法 选取因持续性房颤合并慢心室率行 起搏治疗的患者 56 例,依据心室起搏电极植入部位将其分为右心室间隔部起搏 ( right ventricular septal pacing, RVSP)组(29 例)和 LBBP 组(27 例),并根据临床症状及相关检查结 果,将各组进一步分为心力衰竭(简称心衰)亚组和非心衰亚组,观察两组患者术中及术后 12 个月起搏参数(如阈值、感知和阻抗)、心电图、心脏超声和血浆脑钠肽前体(NT-proBNP)水平 的变化,以及起搏相关并发症、心衰再住院率、新发脑梗死和全因死亡等情况。 结果 ① 两组 间起搏参数比较差异均无统计学意义(P 均>0. 05),两组心衰患者术后 12 个月的 NT-proBNP 水平较术前均有下降,但 RVSP 组心衰亚组下降不明显(P>0. 05)。 ② RVSP 组与术前比较, 术后 12 个月的 LVEF、LVDd 差异无统计学意义(P 均>0. 05); LAD 显著增大(P<0. 05), 二尖 瓣反流明显加重(P<0. 05)。 LBBP 组与术前比较,术后 12 个月 LAD 和二尖瓣反流均无明显 变化(P>0. 05); 心衰患者术后 12 个月 LVEF 升高,LVDd 下降(P 均<0. 05)。 ③ 与术前比较, 两组 QRS 波时限均有延长(P 均<0. 05),且 RVSP 组明显长于 LBBP 组(P<0. 05)。 ④ 两组起 搏相关并发症和心脑血管事件差异无统计学意义(P>0. 05), 再住院率 RVSP 组高于 LBBP 组 (P<0. 05)。 结论 LBBP 在持续性房颤伴慢心室率患者中有助于延缓或逆转心衰患者左心室 重构,改善心脏功能,降低心衰再住院率。 LBBP 应作为慢心室率房颤患者首选的起搏治疗方法。 [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
