A3DR01起搏器对高频心房事件的检出及干预评价

Evaluation of A3DR01 pacemaker on detection and intervention of atrial high rate episodes

目的探讨A3DR01起搏器对高频心房事件(AHRE)的检出、干预作用。方法对2015年6月至2017年3月于华山医院植入A3DR01起搏器的34例患者进行随访观察。对有AHRE的患者进行药物或抗心动过速起搏(Reactive ATP)治疗,对需要进行磁共振扫描的患者进行检查前后及检查过程中参数评估。结果检出有AHRE的患者15例;对有AHRE的患者启动抗心律失常药物治疗,治疗后心房颤动(AF)负荷显著下降(中位数:5%vs 10%,n=15,P<0.05);对药物治疗效果欠佳者开启Reactive ATP治疗,治疗后AF负荷显著下降(中位数:7.45%vs 16%,n=6,P<0.05)。有6例患者进行磁共振检查,检查前后起搏器电极感知、阈值、阻抗等参数无明显变化。结论A3DR01起搏器可以从AHRE的检出、干预到并发症的评估提供全方位的管理方案。

Objective To evaluate the role of A3 DR01 pacemaker on detection and intervention of atrial high rate episodes(AHRE).Methods Thirty-four patients implanted with A3 DR01 pacemaker in Huashan Hospital from June 2015 to March 2017 were followed up.Patients detected AHRE were treated with anti-arrhythmic drug or Reactive ATP(R-ATP)therapy.Patients having the need for MRI were performed with MRI and were interrogated pre-and post-MRI.Results AHRE were detected in fifteen patients and antiarrhythmic drugs were given to the patients.Atrial fibrillation(AF)burden decreased significantly after the administration of the drugs(median:5%vs10%,n=15,P<0.05);R-ATP therapy was given to the patients with weak response to the drugs.AF burden decreased significantly in these patients(median:7.45%vs 16%,n=6,P<0.05).Six patients underwent MRI scan after implanting of pacemaker.There were no overall differences in pre-and post-MRI interrogation of pacemaker lead sensing,threshold or resistance.Conclusions A3 DR01 pacemaker can provide a full range of management from detection and intervention of AHRE to the evaluation of the complications.