JACC:右束支传导阻滞患者经导管瓣膜的选择及其对起搏器植入的影响

2019-11-29 xiangting MedSci原创

在RBBB患者中,与S3相比,NEO的PPI风险明显降低。

这项研究旨在评估ACURATE neoNEO)(波士顿科技,马萨诸塞州马尔伯勒市)与SAPIEN 3S3)(爱德华兹生命科技,加利福尼亚尔湾市)对原有右束支传导阻滞(RBBB)患者经导管主动脉瓣置换后永久性起搏器植入(PPI)的影响。

原有RBBB是经导管主动脉瓣置换后PPI的最强患者相关预测因子。没有关于这类患者使用新一代经导管瓣膜PPI的比较。

这项多中心登记包括4,305名患者。296名患者(6.9%)原有RBBB,并且基线时无起搏器,构成了研究人群。主要终点是30天时的新PPI。在倾向匹配人群中使用二元logistic回归分析和逆概率治疗加权,评估NEO vs.S3PPI的关联。

30天的PPI率为39.2%。S3NEO的使用率分别为66.9%和33.1%。与S3相比,NEO与较低的PPI率相关(29.6vs.43.9%; p=0.025;优势比[OR]0.54 95%置信区间[CI]0.320.89 p=0.018),多因素调整后(OR0.48; 95CI0.260.86; p=0.014),以及逆概率治疗加权分析(OR0.37; 95CI0.250.55; p<0.001)。装置失效(8.2vs. 6.6%;p=0.792)或住院时间无差异。在倾向匹配人群中,NEOPPI率也低于S323.1vs.44.6; p=0.016; OR0.37; 95CI0.170.78; p=0.010),两者间的装置失效无差异(9.2vs. 6.2%; p=0.742)。

RBBB患者中,与S3相比,NEOPPI风险明显降低,这表明了为患者定制经导管心脏瓣膜治疗的可能性。

原始出处:

Oliver Husser. Transcatheter Valve SELECTion in Patients With Right Bundle Branch Block and Impact on Pacemaker Implantations. JACCCardiovascular Interventions.2019.

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    2020-03-22 hbwxf
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    2019-12-01 HNYYM
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1854595, encodeId=a507185459507, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Mar 22 14:31:00 CST 2020, time=2020-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2033949, encodeId=58d42033949af, content=<a href='/topic/show?id=0edb25862cb' target=_blank style='color:#2F92EE;'>#传导阻滞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25862, encryptionId=0edb25862cb, topicName=传导阻滞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f98e185, createdName=psybestwish, createdTime=Thu Jun 11 23:31:00 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1318854, encodeId=78871318854e3, content=<a href='/topic/show?id=bd0292e077b' target=_blank style='color:#2F92EE;'>#起搏器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92707, encryptionId=bd0292e077b, topicName=起搏器)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5494471, createdName=HNYYM, createdTime=Sun Dec 01 03:31:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326422, encodeId=23ca1326422b0, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Dec 01 03:31:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510254, encodeId=e4ba1510254cc, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Sun Dec 01 03:31:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520639, encodeId=25ea1520639fa, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Sun Dec 01 03:31:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583640, encodeId=20a915836408c, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sun Dec 01 03:31:00 CST 2019, time=2019-12-01, status=1, ipAttribution=)]
    2019-12-01 lsj631
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    2019-12-01 jiyangfei
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