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首页> 外文期刊>Circulation journal >Effcacy of hemodynamic-based management of tachyarrhythmia after repair of tetralogy of fallot
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Effcacy of hemodynamic-based management of tachyarrhythmia after repair of tetralogy of fallot

机译：法洛四联症修复后基于血流动力学的快速性心律失常管理的疗效

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Background: Supraventricular and ventricular tachyarrhythmias (SVT, VT) are major concerns after repair of tetralogy of Fallot (TOF). This study evaluated the impact of comprehensive treatment, including hemodynamic interventions such as surgery, catheter-based intervention and pacemaker implantation (PMI), on tachyarrhythmia in repaired TOF patients. Methods and Results: Of 66 repaired TOF patients with tachyarrhythmia (age at onset, 23±11 years), 29 patients had sustained SVT, 21 had sustained or non-sustained VT, and 16 had both (SVT+VT). Successful treatment with catheter-directed ablation and/or anti-arrhythmic drugs (AADs) alone was achieved in 31 (69%) and partially achieved in 6 (13%) of 45 patients. Surgery, catheter-based intervention, and/or PMI were performed in 21 (32%) of 66 patients and resulted in complete control of the arrhythmia in 8 (38%) and partial control in 7 (33%) of these 21 patients, 20 (95%) of whom were receiving AADs. Patients with successfully controlled tachyarrhythmia in response to catheter ablation and/or AADs without hemodynamic intervention had a significantly higher probability of absence of sinus node dysfunction (odds ratio [OR], 23.2; 95% confidence interval [CI], 1.8-845.2; P=0.02) and lone intra-atrial reentrant tachycardia (OR, 12.4; 95% CI: 1.3-278.7; P=0.03). Conclusions: Hemodynamic interventions resulted in an improvement in outcomes in repaired TOF patients with tachyarrhythmia. To effectively manage intractable tachyarrhythmia with hemodynamic abnormalities, it is essential to understand hemodynamics and consider hemodynamic intervention.
机译：背景：法洛四联症（TOF）修复后，室上和室性快速性心律失常（SVT，VT）是主要问题。这项研究评估了综合治疗（包括手术，基于导管的介入和起搏器植入（PMI）等血液动力学干预）对修复的TOF患者心律失常的影响。方法和结果：在66例修复的TOF快慢性心律失常患者中（发病年龄23±11岁），有29例持续SVT，21例持续或非持续VT，以及16例同时发生（SVT + VT）。仅导管定向消融和/或抗心律不齐药物（AAD）的成功治疗在45例患者中有31例（69％）获得了部分成功，在6例（13％）中得到了部分成功。 66例患者中有21例（32％）进行了手术，基于导管的干预和/或PMI，这21例患者中有8例（38％）完全控制了心律不齐，7例（33％）完全控制了心律失常，其中20（95％）人正在接受AAD。在没有进行血液动力学干预的情况下，成功地控制了导管消融和/或AAD的快速性心律失常的患者出现窦房结功能障碍的可能性明显更高（几率[OR]为23.2; 95％置信区间[CI]为1.8-845.2; P = 0.02）和单独的房内折返性心动过速（OR，12.4; 95％CI：1.3-278.7; P = 0.03）。结论：血流动力学干预导致TOF修复性快速性心律失常患者的预后得到改善。为了有效处理伴有血流动力学异常的顽固性快速性心律失常，必须了解血流动力学并考虑进行血流动力学干预。

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