Department of Cardiology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Hebei International Joint Research Center for Structural Heart Disease, Shijiazhuang, Hebei, People's Republic of China.
Braz J Cardiovasc Surg. 2023 Oct 23;38(5):e2023144. doi: 10.21470/1678-9741-2023-0144.
To investigate the risk factors for predicting atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs).
A total of 140 patients with CIED in our hospital from June 2013 to June 2018 were included and were followed up to observe whether they had AHREs. AHRE are defined as atrial rate ≥ 175 times/minute, lasting > 5 minutes, and reviewed by an experienced electrophysiologist with unclear clinical diagnosis. The patients fasted for 12 hours after implantation, and blood samples were collected for biochemical, lipid, and whole blood count detection. Follow-up was regular after discharge to record follow-up data of each patient and conduct statistical analysis.
One hundred and forty patients were implanted with dual-chamber pacemakers, their median age was 70 years old, 44.29% were male, 27 patients had AHRE within one year, and AHRE incidence rate was 19.29%. The microcytic to hypochromic (M/H) ratio was calculated for all AHRE patients and compared with the patients without AHRE; the M/H value of AHRE patients was significantly higher. Throughout the entire follow-up period, a total of 44 patients developed AHRE; when adjusted by multivariate analysis, only M/H ratio ≥ 4.5 vs. < 4.5 had statistical significance, and the adjusted hazard ratio value was 4.313 (1.675-11.105).
As an indicator, M/H ratio may play an important role in the occurrence and development of atrial fibrillation and can be used as a predictor of AHRE in patients with CIED.
探讨心脏植入式电子设备(CIED)检测到的心房高频事件(AHREs)的预测因素。
选取我院 2013 年 6 月至 2018 年 6 月期间植入 CIED 的 140 例患者进行随访,观察是否发生 AHREs。AHRE 定义为心房率≥175 次/分钟,持续时间>5 分钟,由经验丰富的电生理学家进行评估,临床诊断不明确。患者植入后禁食 12 小时,采集血样进行生化、血脂和全血细胞计数检测。出院后定期随访,记录每位患者的随访资料并进行统计分析。
140 例患者植入双腔起搏器,中位年龄为 70 岁,44.29%为男性,1 年内有 27 例发生 AHRE,发生率为 19.29%。计算所有 AHRE 患者的小细胞低色素(M/H)比值,并与无 AHRE 患者进行比较;AHRE 患者的 M/H 值明显更高。整个随访期间,共有 44 例患者发生 AHRE;经多因素分析调整后,只有 M/H 比值≥4.5 与<4.5 比较具有统计学意义,调整后的危险比为 4.313(1.675-11.105)。
作为一个指标,M/H 比值可能在心房颤动的发生和发展中起重要作用,可以作为 CIED 患者 AHRE 的预测因子。