ClinicalCardiology插

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ClinicalpredictorsforbradycardiaandsupraventriculartachycardianecessitatingtherapyinpatientswithunexplainedsyncopemonitoredbyinsertablecardiacmonitorClinicalCardiologyArticleEarlyRecent,Mar16,./clc.本文由“天纳”临床学术信息人工智能系统自动翻译点击文末“阅读原文”下载本文PDFBackgroundInsertablecardiacmonitors(ICMs)improvediagnosticyieldinpatientswithunexplainedsyncope.Themostofcardiacsyncopeisarrhythmiccausesincludeparoxysmalbradycardiaandsupraventriculartachycardia(SVT)inpatientswithunexplainedsyncopereceivingICM.PredictorsforbradycardiaandSVTthatnecessitatetherapyinpatientswithunexplainedsyncopearenotwellknown.可插入式心脏监护仪（ICMs）可提高不明原因晕厥患者的诊断率。心源性晕厥的主要原因是心律失常，包括接受ICM的不明原因晕厥患者的阵发性心动过缓和室上性心动过速（SVT）。不明原因晕厥患者需要治疗的心动过缓和SVT的预测因素尚不清楚。HypothesisThisstudyaimedtoinvestigatepredictorsofbradycardiaandSVTnecessitatingtherapyinpatientswithunexplainedsyncopereceivingICMs.本研究旨在探讨接受ICMs治疗的不明原因晕厥患者心动过缓和SVT的预测因素。MethodsWeretrospectivelyreviewedmedicalrecordsofconsecutivepatientswhoreceivedICMstomonitorunexplainedsyncope.WeperformedCoxsstepwiselogisticregressionanalysistoidentifysignificantindependentpredictorsforbradycardiaandSVT.我们回顾性分析了连续接受ICMs监测不明原因晕厥患者的病历。我们进行Cox逐步logistic回归分析以确定心动过缓和SVT的重要独立预测因素。ResultsOnehundredthirty‐twopatientsreceivedICMstomonitorunexplainedsyncope.Duringthe17‐monthfollow‐upperiod,19patients(14%)neededpacemakertherapyforbradycardia;8patients(6%)receivedcatheterablationforSVT.Thetotalestimateddiagnosticrateswere34%and48%at1and2?years,respectively.Stepwiselogisticregressionanalysisindicatedthatsyncopeduringeffort(oddsratio[OR]=3.41;95%confidenceinterval[CI],1.21to9.6;p=.02)wasanindependentpredictorforbradycardia.Palpitationbeforesyncope(OR=9.46;95%CI,1.78to50.10;p=.)andhistoryofatrialfibrillation(OR=10.1;95%CI,1.96to52.45;p=.)wereidentifiedassignificantindependentpredictorsforSVT.名患者接受ICMs监测不明原因晕厥。在17个月的随访期间，19名患者（14%）因心动过缓需要起搏器治疗；8名患者（6%）因SVT接受导管消融治疗。1年和2年的总估计诊断率分别为34%和48%。逐步logistic回归分析表明，用力时晕厥（优势比[OR]=3.41；95%可信区间[CI]，1.21~9.6；p=.02）是心动过缓的独立预测因素。晕厥前心悸（OR=9.46；95%CI，1.78~50.10；p=0.）和房颤史（OR=10.1；95%CI，1.96~52.45；p=0.）被认为是SVT的重要独立预测因子。ConclusionSyncopeduringeffort,andpalpitationsorhistoryofatrialfibrillationwereindependentpredictorsforbradycardiaandforSVT.ICMsareusefuldevicesfordiagnosingunexplainedsyncope.用力时晕厥、心悸或房颤史是心动过缓和SVT的独立预测因素。ICMs是诊断不明原因晕厥的有效工具。1INTRODUCTIONSyncopehasvariouscauses,andtheprognosisdiffersaccordingtothecause.1Whenconventionaltestsdonotindicatethecause,thediagnosisisunexplainedsyncope.Ofallpatientswithsyncopepatientsindedicatedfacilities,18%to20%hadunexplainedsyncope.2-4Ourpreviousreportalsoindicatedthattherewas23.9%incidenceofallsyncope.5Insertablecardiacmonitors(ICMs)allowforlengthymonitoringofcardiacrhythmandimproveddiagnosticyieldamongpatientswithunexplainedsyncope.6-8RemotemonitoringsystemswithICMshavealsobe

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