河北医大二院研究称,两成双腔起搏器术后患者发生房颤,起搏模式是关键

2019-01-04 朱朱 中国循环杂志

河北医科大学第二医院心内科刘倩、谢瑞芹等报告,在该院双腔起搏器植入术后患者中,房颤的发生率高达22.35%。 多因素Logistic 回归分析表明,采用心房起搏-心室起搏(AP-VP)模式起搏、左心房内径增大的患者容易发生房颤,而应用钙拮抗剂可减少房颤发生。


河北医科大学第二医院心内科刘倩、谢瑞芹等报告,在该院双腔起搏器植入术后患者中,房颤的发生率高达22.35%。

多因素Logistic 回归分析表明,采用心房起搏-心室起搏(AP-VP)模式起搏、左心房内径增大的患者容易发生房颤,而应用钙拮抗剂可减少房颤发生。

研究者指出,左心房增大已经是国内外公认的术后房颤的独危险因素。

AP-VP模式对房颤发生的有害影响可能与心房压力增高和收缩性损伤有关,而不是心房扩大本身。

该研究发现,随着AP-VP模式比例增加,房颤发生率趋于稳定,这可能是由于长期起搏治疗使患者对心脏起搏有更好的耐受性。

因此,临床上应尽量减少AP-VP模式比例,从而降低房颤发生率。目前,具有房室搜索功能和心室起搏管理功能(MVP)的起搏器可以有效降低AP-VP 模式比例。

研究者回顾性选择2014年3月至2017年10月于该院因病态窦房结综合征和(或)高度房室阻滞首次植入双腔起搏器的无房颤病史患者85 例,其中病态窦房结综合征患者36 例,高度房室阻滞患者41 例,病态窦房结综合征合并高度房室阻滞患者8 例。术后平均随访1年多(387天)。

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    2019-01-08 orangesking

    0

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    2019-01-08 Kanmibaby

    学习

    0

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    2019-01-06 HNYYM
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    2019-01-05 龙胆草

    学习谢谢分享

    0

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    2019-01-04 医者仁心5538

    学习了

    0