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南京医院学者Meta分析研究显示:一成TAVR术后患者将新发房颤

2016-12-02 朱灏, 任晓敏, 蔡金赞, 等. 中国循环杂志, 2016, 31: 11

经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注。南京医科大学附属南京医院张瑶俊、朱灏等进行的Meta分析研究发现,TAVR术后新发房颤并不少见,发生率为11.1%。 此外,经心尖途、手术相关心脏事件、手术相关出血事件、心房过大(每增加1 mm/m2),均是TAVR术后新发房颤的独立预测因素。 而且,这些因素均有相应引起房颤的机制。比如经心尖途径容易引起新发房颤可能与胸廓

经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注。南京医科大学附属南京医院张瑶俊、朱灏等进行的Meta分析研究发现,TAVR术后新发房颤并不少见,发生率为11.1%。
 
此外,经心尖途、手术相关心脏事件、手术相关出血事件、心房过大(每增加1 mm/m2),均是TAVR术后新发房颤的独立预测因素。
 
而且,这些因素均有相应引起房颤的机制。比如经心尖途径容易引起新发房颤可能与胸廓切开术中通气限制以及术后疼痛所引起的高肾上腺素状态有关。
 
有研究显示,新发房颤患者1年死亡率明显增高。值得注意的是,各研究所报道的TAVR 术后新发房颤的发生时间基本上集中在术后72 h 内,占发病患者的86.36%~100%,发病后持续时间主要集中在48~72小时。
 
研究者指出,这提示临床医生应该是实际中注重术后72小时心电监护,以期早期发现。
 
但目前对是否需要早期复律治疗,以及如何进行复律治疗,还有待进一步研究。正在进行的BRAVO-3研究或许在未来能有所提示。
 
该研究共纳入2009-01 至2016-01期间发表的14项研究,共包括6626例行TAVR的严重主动脉狭窄患者。其中4项研究为多中心随机对照研究。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1887585, encodeId=1cef188e58530, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Sep 05 07:37:00 CST 2017, time=2017-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189762, encodeId=795b189e6239, content=跟技术有没有关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92a11943582, createdName=ALY, createdTime=Sun Apr 23 02:05:04 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086308, encodeId=497720863080f, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Sep 16 15:37:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895976, encodeId=d21818959e69a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Apr 15 10:37:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481368, encodeId=effa1481368e1, content=<a href='/topic/show?id=ce0258131ff' target=_blank style='color:#2F92EE;'>#新发房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58131, encryptionId=ce0258131ff, topicName=新发房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=788d7780866, createdName=若水125, createdTime=Sun Dec 04 08:37:00 CST 2016, time=2016-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159781, encodeId=0a71159e8176, content=经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注,TAVR术后新发房颤并不少见,发生率为11.1%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Fri Dec 02 23:57:10 CST 2016, time=2016-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159738, encodeId=a954159e389e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Fri Dec 02 18:53:31 CST 2016, time=2016-12-02, status=1, ipAttribution=)]
    2017-09-05 guojianrong
  2. [GetPortalCommentsPageByObjectIdResponse(id=1887585, encodeId=1cef188e58530, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Sep 05 07:37:00 CST 2017, time=2017-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189762, encodeId=795b189e6239, content=跟技术有没有关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92a11943582, createdName=ALY, createdTime=Sun Apr 23 02:05:04 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086308, encodeId=497720863080f, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Sep 16 15:37:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895976, encodeId=d21818959e69a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Apr 15 10:37:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481368, encodeId=effa1481368e1, content=<a href='/topic/show?id=ce0258131ff' target=_blank style='color:#2F92EE;'>#新发房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58131, encryptionId=ce0258131ff, topicName=新发房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=788d7780866, createdName=若水125, createdTime=Sun Dec 04 08:37:00 CST 2016, time=2016-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159781, encodeId=0a71159e8176, content=经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注,TAVR术后新发房颤并不少见,发生率为11.1%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Fri Dec 02 23:57:10 CST 2016, time=2016-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159738, encodeId=a954159e389e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Fri Dec 02 18:53:31 CST 2016, time=2016-12-02, status=1, ipAttribution=)]
    2017-04-23 ALY

    跟技术有没有关系

    0

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    2017-04-15 一闲
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1887585, encodeId=1cef188e58530, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Sep 05 07:37:00 CST 2017, time=2017-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189762, encodeId=795b189e6239, content=跟技术有没有关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92a11943582, createdName=ALY, createdTime=Sun Apr 23 02:05:04 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086308, encodeId=497720863080f, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Sep 16 15:37:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895976, encodeId=d21818959e69a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Apr 15 10:37:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481368, encodeId=effa1481368e1, content=<a href='/topic/show?id=ce0258131ff' target=_blank style='color:#2F92EE;'>#新发房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58131, encryptionId=ce0258131ff, topicName=新发房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=788d7780866, createdName=若水125, createdTime=Sun Dec 04 08:37:00 CST 2016, time=2016-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159781, encodeId=0a71159e8176, content=经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注,TAVR术后新发房颤并不少见,发生率为11.1%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Fri Dec 02 23:57:10 CST 2016, time=2016-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159738, encodeId=a954159e389e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Fri Dec 02 18:53:31 CST 2016, time=2016-12-02, status=1, ipAttribution=)]
    2016-12-02 inter158

    经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注,TAVR术后新发房颤并不少见,发生率为11.1%。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1887585, encodeId=1cef188e58530, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Tue Sep 05 07:37:00 CST 2017, time=2017-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189762, encodeId=795b189e6239, content=跟技术有没有关系, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92a11943582, createdName=ALY, createdTime=Sun Apr 23 02:05:04 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086308, encodeId=497720863080f, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Sep 16 15:37:00 CST 2017, time=2017-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1895976, encodeId=d21818959e69a, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Sat Apr 15 10:37:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1481368, encodeId=effa1481368e1, content=<a href='/topic/show?id=ce0258131ff' target=_blank style='color:#2F92EE;'>#新发房颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58131, encryptionId=ce0258131ff, topicName=新发房颤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=788d7780866, createdName=若水125, createdTime=Sun Dec 04 08:37:00 CST 2016, time=2016-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159781, encodeId=0a71159e8176, content=经导管主动脉瓣置换术(TAVR)后新发房颤逐渐引起关注,TAVR术后新发房颤并不少见,发生率为11.1%。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151226/IMG567EB873985DE3928.jpg, createdBy=ea941622301, createdName=inter158, createdTime=Fri Dec 02 23:57:10 CST 2016, time=2016-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=159738, encodeId=a954159e389e, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161224/IMG585DA5E26B9F44696.jpg, createdBy=565a98798, createdName=susice, createdTime=Fri Dec 02 18:53:31 CST 2016, time=2016-12-02, status=1, ipAttribution=)]
    2016-12-02 susice

    值得关注

    0

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