经导管主动脉瓣植入术后永久起搏器植入患者的传导障碍恢复率

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Open Heart Pub Date : 2024-09-01 DOI:10.1136/openhrt-2024-002867
Maria Yamamoto, Arudo Hiraoka, Toshinobu Yoshida, Satoru Kishimoto, Genta Chikazawa, Hidenori Yoshitaka
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引用次数: 0

摘要

背景 永久起搏器植入术(PPMI)是经导管主动脉瓣植入术(TAVI)的最大弊端之一。为了寻找 PPMI 的预测因素和临床影响,并调查传导障碍的恢复率。方法 我们回顾性分析了2013年11月至2022年7月期间因重度主动脉瓣狭窄接受TAVI的745例连续患者的数据。记录了 PPMI 术后 1 个月和 6 个月的心室起搏(VP)率,并将 VP 率小于 1% 定义为传导障碍恢复。结果 7.1%(53/745)的患者在术后进行了 PPMI。PPMI(-)组的球囊预扩张率明显更高(52.8% (28/53) vs 80.6% (558/692);P<0.001),PPMI(+)组的过大率明显更高(11.8%±10.1% vs 9.1%±9.7%;P=0.035)。PPMI(-)组患者因心力衰竭而免于再次住院的比例明显更高(P=0.032)。在术后 PPMI 患者中,分别有 17.0% 和 27.9% 的患者在 1 个月和 6 个月时从传导障碍中恢复过来。结论 传导障碍的恢复是经常发生的。避免尺寸过大和延长观察时间可减少 TAVI 术后对 PPMI 的需求。如有合理要求,可提供相关数据。
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Recovery rate from conduction disorders in patients with permanent pacemaker implantation after transcatheter aortic valve implantation
Backgrounds Permanent pacemaker implantation (PPMI) is one of the greatest disadvantages of transcatheter aortic valve implantation (TAVI). To seek the predictors and clinical impacts of PPMI and investigate the recovery rate from conduction disorders. Methods We retrospectively analysed data from 745 consecutive patients who underwent TAVI for severe aortic stenosis from November 2013 to July 2022. The ventricular pacing (VP) rate was recorded at 1 and 6 months after PPMI and the recovery from conduction disorders was defined as the VP rate <1%. Results Postoperative PPMI was performed in 7.1% (53/745) of patients. Balloon predilatation was significantly frequent in the PPMI (−) group (52.8% (28/53) vs 80.6% (558/692); p<0.001) and the oversizing ratio was significantly greater in the PPMI (+) group (11.8%±10.1% vs 9.1%±9.7%; p=0.035). Freedom from rehospitalisation due to heart failure rate was significantly higher in the PPMI (−) group (p=0.032). In patients with postoperative PPMI, recovery from conduction disorders was observed in 17.0% and 27.9% of patients at 1 and 6 months, respectively. Conclusions Recovery from conduction disorders occurred frequently. Avoidance of oversizing and extension of observation time may reduce the need for PPMI after TAVI. Data are available on reasonable request.
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来源期刊
Open Heart
Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
3.70%
发文量
145
审稿时长
20 weeks
期刊介绍: Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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