Văcărescu Cristina, Cozma Dragoș, Crișan Simina, Gaiță Dan, Anutoni Debora-Delia, Margan Mădălin-Marius, Faur-Grigori Adelina-Andreea, Roteliuc Romina, Luca Silvia-Ana, Lazăr Mihai-Andrei, Pătru Oana, Cirin Liviu, Baneu Petru, Luca Constantin-Tudor
Department of Cardiology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania.
J Clin Med. 2024 Aug 15;13(16):4814. doi: 10.3390/jcm13164814.
: When compared to biventricular pacing, fusion CRT pacing was linked to a decreased incidence of atrial fibrillation (AF). There is a gap in the knowledge regarding exclusive fusion CRT without interference with RV pacing, and all the current data are based on populations of patients with intermittent fusion pacing. : To assess left atrium remodeling and AF incidence in a real-life population of permanent fusion CRT-P. : Retrospective data were analyzed from a cohort of patients with exclusive fusion CRT-P. Device interrogation, exercise testing, transthoracic echocardiography (TE), and customized medication optimization were all part of the six-monthly individual follow-up. : Study population: 73 patients (38 males) with non-ischemic dilated cardiomyopathy aged 63.7 ± 9.3 y.o. Baseline characteristic: QRS 159.8 ± 18.2 ms; EF 27.9 ± 5.1%; mitral regurgitation was severe in 38% of patients, moderate in 47% of patients, and mild in 15% of patients; 43% had type III diastolic dysfunction (DD), 49% had type II DD, 8% had type I DD. Average follow-up was 6.4 years ± 27 months: 93% of patients were responders (including 31% super-responders); EF increased to 40.4 ± 8.5%; mitral regurgitation decreased in 69% of patients; diastolic profile improved in 64% of patients. Paroxysmal and persistent AF incidence was 11%, with only 2% of patients developing permanent AF. Regarding LA volume, statistically significant LA reverse remodeling was observed. : Exclusive fusion CRT-P was associated with important LA reverse remodeling and a low incidence of AF.
与双心室起搏相比，融合CRT起搏与房颤（AF）发生率降低有关。关于无右心室起搏干扰的单纯融合CRT，目前存在知识空白，所有现有数据均基于间歇性融合起搏患者群体。：评估永久性融合CRT-P真实生活人群中的左心房重塑和房颤发生率。：对一组单纯融合CRT-P患者的回顾性数据进行分析。设备问询、运动测试、经胸超声心动图（TE）以及定制的药物优化均为每六个月一次的个体随访的一部分。：研究人群：73例（38例男性）非缺血性扩张型心肌病患者，年龄63.7±9.3岁。基线特征：QRS 159.8±18.2毫秒；射血分数（EF）27.9±5.1%；38%的患者二尖瓣反流严重，47%的患者中度反流，15%的患者轻度反流；43%的患者有III型舒张功能障碍（DD），49%的患者有II型DD，8%的患者有I型DD。平均随访6.4年±27个月：93%的患者有反应（包括31%的超级反应者）；EF增至41 ± 8.5%；69%的患者二尖瓣反流减轻；64%的患者舒张功能改善。阵发性和持续性房颤发生率为11%，仅2%的患者发展为永久性房颤。关于左心房容积，观察到有统计学意义的左心房逆向重塑。：单纯融合CRT-P与重要的左心房逆向重塑和低房颤发生率相关。
