沙库巴曲缬沙坦对植入了心脏除颤器的心力衰竭患者室性心律失常发生的影响

Sacubitril/valsartan affects ventricular arrhythmias in heart failure patients with CRTD or ICD implantation

目的探讨沙库巴曲缬沙坦对心脏再同步化心脏转复除颤器(CRTD)或埋藏式心脏转复除颤器(ICD)植入的射血分数降低的心力衰竭患者室性心律失常发生的影响.方法在18例植入CRTD或ICD射血分数降低的心力衰竭患者中,通过分析器械提供的室性心动过速/心室颤动(简称室速/室颤)计数(VT/VF Counters)及心脏指南针报告中记录的数据,比较使用沙库巴曲缬沙坦6个月前后室性心律失常的发生情况.结果应用沙库巴曲缬沙坦后,与治疗前相比,非持续性室速及室速/室颤事件均有减少(P=0.035和0.017);而单发室性早搏、连续室性早搏、监测室速及电风暴事件均无统计学差异(P>0.05).结论沙库巴曲缬沙坦可进一步减少射血分数降低的心力衰竭患者非持续性室速及室速/室颤事件的发生,从而减少ICD干预治疗.

Objective To investigate the effect of sacubitril/valsartan on ventricular arrhythmias in heart failure with reduced ejection fraction patients with cardiac resynchronization cardioverter defibrillator(CRTD) or implantable cardioverter defibrillator(ICD) implantation. Methods Eighteen patients with CRTD or ICD implantation were compared with ventricular arrhythmias before and after the use of sacubitril/valsartan by analyzing the data recorded in ventricular tachycardia/fibrillation(VT/VF) Counters and Cardiac Campass Report provided by the devices. Results Compared with before sacubitril/valsartan treatment, there was a decrease in both nonsustained VT(VT-NS) and VT/VF(P=0.035 and 0.017).There were no statistically significant differences in the events of premature ventricular contraction(PVC) singles, PVC Runs, Monitored VT, and Electronic Strom(P>0.05). Conclusion The occurrence of VT-NS and VT/VF events in patients with heart failure with reduced ejection fraction can be further reduced by sacubitril/valsartan, thereby reducing ICD intervention.