心脏再同步治疗后超声心动图引导下房室优化期间的心率加速起搏
Pacing at accelerated heart rate during echocardiography-guided atrioventricular optimisation following cardiac resynchronisation therapy.
作者信息
Spevack Daniel M, Chirumamilla Amala, Aronow Wilbert S
机构信息
Division of Cardiology, Department of Medicine, Montefiore Medical Centre and Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Cardiology, Westchester Medical Centre and New York Medical College, Valhalla, New York, USA.
出版信息
Arch Med Sci Atheroscler Dis. 2020 Sep 10;5:e230-e236. doi: 10.5114/amsad.2020.98928. eCollection 2020.
INTRODUCTION
Although echo-guided atrioventricular optimisation (AVO) is standardly performed at rest, this approach may not provide optimal AV synchrony during daily activities.
MATERIAL AND METHODS
The AVO protocol at one of two hospital campuses had been modified to be performed while pacing at an accelerated heart rate. We tested if this approach would improve the yield from AVO compared to the other campus, where AVO was performed at the intrinsic sinus rate.
RESULTS
Between campuses, no significant differences were seen in demographics, chamber sizes, left ventricular ejection fraction, and diastolic function grade. Those having AVO at C2 were more likely to demonstrate "fusion prone" physiology (36% vs. 9%; = 0.006) and were more likely to display either "truncation- or fusion-prone" physiology (58% vs. 27%; = 0.007).
CONCLUSIONS
When AVO was performed at an accelerated heart rate, patients with "truncation-prone" or "fusion-prone" physiology were identified more readily.
引言
尽管超声心动图引导下的房室优化（AVO）通常在静息状态下进行，但这种方法可能无法在日常活动期间提供最佳的房室同步。
材料与方法
两个医院院区之一的AVO方案已被修改为在心率加快时进行起搏的同时实施。我们测试了与另一个以固有窦性心律进行AVO的院区相比，这种方法是否会提高AVO的成功率。
结果
在两个院区之间，在人口统计学、腔室大小、左心室射血分数和舒张功能分级方面未观察到显著差异。在C2进行AVO的患者更有可能表现出“易融合”的生理状态（36%对9%；P = 0.006），并且更有可能表现出“易截断或易融合”的生理状态（58%对27%；P = 0.007）。
结论
当在心率加快时进行AVO时，更容易识别出具有“易截断”或“易融合”生理状态的患者。
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