病态窦房结综合征患者的动脉血栓栓塞：根据起搏模式、心房颤动及超声心动图检查结果进行预测

Arterial thromboembolism in patients with sick sinus syndrome: prediction from pacing mode, atrial fibrillation, and echocardiographic findings.

作者信息

Andersen H R, Nielsen J C, Thomsen P E, Thuesen L, Pedersen A K, Mortensen P T, Vesterlund T

机构信息

Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark.

出版信息

Heart. 1999 Apr;81(4):412-8. doi: 10.1136/hrt.81.4.412.

DOI:10.1136/hrt.81.4.412

PMID:10092569

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1729005/

Abstract

OBJECTIVE

To evaluate whether thromboembolism in sick sinus syndrome can be predicted by pacing mode, atrial fibrillation, or echocardiographic findings.

METHODS

Patients were randomised to single chamber atrial (n = 110) or ventricular (n = 115) pacing. They were divided into subgroups with and without brady-tachy syndrome at time of randomisation. The occurrence of atrial fibrillation and thromboembolism during follow up were investigated and compared with echocardiographic findings.

RESULTS

The annual risk of thromboembolism was 5.8% in patients with brady-tachy syndrome randomised to ventricular pacing, 3.2% in patients without brady-tachy syndrome randomised to ventricular pacing, 3% in patients with brady-tachy syndrome randomised to atrial pacing, and 1.5% in patients without brady-tachy syndrome randomised to atrial pacing. In atrial paced patients without brady-tachy syndrome at randomisation and without atrial fibrillation during follow up, the annual risk of thromboembolism was 1.4%. Left atrial size measured by M mode echocardiography was of no value in predicting thromboembolism.

CONCLUSIONS

Arterial thromboembolism in patients with sick sinus syndrome is very common and is associated primarily with brady-tachy syndrome at randomisation and with ventricular pacing. The risk of thromboembolism is small in atrial paced patients in whom atrial fibrillation has never been documented.

摘要

目的

评估病窦综合征中的血栓栓塞是否可通过起搏模式、心房颤动或超声心动图检查结果进行预测。

方法

将患者随机分为单腔心房起搏组（n = 110）和心室起搏组（n = 115）。根据随机分组时是否存在慢快综合征将患者进一步分为亚组。对随访期间心房颤动和血栓栓塞的发生情况进行调查，并与超声心动图检查结果进行比较。

结果

随机分组至心室起搏的慢快综合征患者中，血栓栓塞的年发生率为5.8%；随机分组至心室起搏但无慢快综合征的患者中，该发生率为3.2%；随机分组至心房起搏的慢快综合征患者中，发生率为3%；随机分组至心房起搏且无慢快综合征的患者中，发生率为1.5%。在随机分组时无慢快综合征且随访期间无心房颤动的心房起搏患者中，血栓栓塞的年发生率为1.4%。M型超声心动图测量的左心房大小对预测血栓栓塞无价值。