Gabriels James, Wu Michael, Rosen Lisa, Patel Apoor, Goldner Bruce
Department of Cardiology, Long Island Jewish Hospital, New Hyde Park, New York.
Pacing Clin Electrophysiol. 2016 Dec;39(12):1335-1339. doi: 10.1111/pace.12968. Epub 2016 Dec 2.
Permanent pacemaker electrograms record a variety of arrhythmias, including nonsustained ventricular tachycardia (NSVT). Little has been reported regarding incidence and clinical significance of NSVT in pacemaker patients after long-term monitoring.
Records from all patients implanted with Medtronic pacemakers (Medtronic, Minneapolis, MN, USA) at a single institution from January 1, 2009 to February 27, 2012 were reviewed. Demographic characteristics, imaging studies, pacemaker interrogations, and the Social Security Death Index were examined in patients older than 18 years of age who had ≥ 2 follow-up device interrogations.
A total of 262 patients with an ejection fraction (EF) >40% were included in the final analysis with a mean follow-up of 29.2 months. Of these patients, 83.2% (n = 218) had hypertension (HTN) and 45.4% (n = 119) had NSVT. Among patients with an EF ≥ 55%, hypertensive patients had a NSVT burden 2.46 times greater than normotensive patients (incidence rate ratio: 2.46, 95% confidence interval: 1.10-5.50; P < 0.028). NSVT was not associated with increased mortality (P < 0.1229).
In this cohort of patients, there was a high prevalence of HTN and while hypertensive subjects had a significantly higher NSVT burden, NSVT was not associated with an increased mortality.
永久性起搏器心电图可记录多种心律失常,包括非持续性室性心动过速(NSVT)。关于长期监测后起搏器患者中NSVT的发生率及临床意义,鲜有报道。
回顾了2009年1月1日至2012年2月27日在单一机构植入美敦力起搏器(美敦力,明尼阿波利斯,明尼苏达州,美国)的所有患者的记录。对年龄≥18岁且有≥2次随访设备问询的患者,检查其人口统计学特征、影像学研究、起搏器问询情况以及社会保障死亡指数。
最终分析纳入了262例射血分数(EF)>40%的患者,平均随访29.2个月。在这些患者中,83.2%(n = 218)患有高血压(HTN),45.4%(n = 119)患有NSVT。在EF≥55%的患者中,高血压患者的NSVT负荷比血压正常的患者高2.46倍(发病率比:2.46,95%置信区间:1.10 - 5.50;P < 0.028)。NSVT与死亡率增加无关(P < 0.1229)。
在该队列患者中,HTN患病率较高,虽然高血压患者的NSVT负荷显著更高,但NSVT与死亡率增加无关。