Abdullah Khaled Q A, Roedler Jana V, Vom Dahl Juergen, Szendey Istvan, Dimitroulis Dimitrios, Eckardt Lars, Topf Albert, Ohnewein Bernhard, Fritsch Lorenz, Föttinger Fabian, Brandt Mathias C, Wernly Bernhard, Motloch Lukas J, Larbig Robert
Department of Cardiology, Hospital Maria Hilf Moenchengladbach, 41063 Moenchengladbach, Germany.
Department of Cardiology, University Hospital Aachen, RWTH University Aachen, 52062 Aachen, Germany.
J Clin Med. 2021 Mar 31;10(7):1393. doi: 10.3390/jcm10071393.
In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella assist device between 2008 and 2018. Rhythm monitoring is investigated in this population and associations with hospital survival are analyzed. Hospital mortality is high, at 83.5%. Diverse cardiac arrhythmias are frequently registered during Impella treatment. These include atrial fibrillation (AF, 21.1%) and ventricular tachycardia (VT, 18.3%), as well as AV block II°/III° (AVB, 7.3%), while intermittent asystole (ASY) is the most frequently observed arrhythmia (42.2%). Nevertheless, neither ventricular nor supraventricular tachycardias are associated with patients' survival. In patients who experience intermittent asystole, a trend towards a fatal outcome is noted ( = 0.06). Conclusions: Mortality is high in these severely sick patients. While cardiac arrhythmias were frequent, they did not predict hospital mortality in this population. The hemodynamic support of the pump seems to counterbalance the adverse effects of these events.
在这项回顾性单中心试验中，我们分析了2008年至2018年间109例连续发生心脏性猝死（SCD）且需要Impella辅助装置进行血流动力学支持的患者（女性占27.5%，中位年龄69岁，左心室射血分数中位数为20%）。对该人群进行了心律监测，并分析了其与住院生存率的相关性。医院死亡率很高，为83.5%。在Impella治疗期间经常记录到各种心律失常。这些心律失常包括心房颤动（AF，21.1%）、室性心动过速（VT，18.3%）以及二度/三度房室传导阻滞（AVB，7.3%），而间歇性心脏停搏（ASY）是最常观察到的心律失常（42.2%）。然而，室性或室上性心动过速均与患者生存率无关。在经历间歇性心脏停搏的患者中，有出现致命结局的趋势（P = 0.06）。结论：这些重症患者死亡率很高。虽然心律失常很常见，但它们并不能预测该人群的医院死亡率。泵的血流动力学支持似乎能抵消这些事件的不良影响。
