吸入性心律失常综合征中的房性心律失常:TETRIS 研究结果。

IF 7.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Europace Pub Date : 2024-11-11 DOI:10.1093/europace/euae288
Giulio Conte, Marco Bergonti, Vincent Probst, Hiroshi Morita, Jacob Tfelt-Hansen, Elijah R Behr, Kusano Kengo, Elena Arbelo, Lia Crotti, Georgia Sarquella-Brugada, Arthur A M Wilde, Leonardo Calò, Andrea Sarkozy, Carlo de Asmundis, Greg Mellor, Federico Migliore, Kostantinos Letsas, Alessandro Vicentini, Moises Levinstein, Paola Berne, Shih-Ann Chen, Christian Veltmann, Elżbieta Katarzyna Biernacka, Paula Carvalho, Mihoko Kabawata, Kyoko Sojema, Maria Cecilia Gonzalez, Gary Tse, Aurélie Thollet, Jesper Svane, Maria Luce Caputo, Chiara Scrocco, Tsukasa Kamakura, Livia Franchetti Pardo, Sharen Lee, Christian Krijger Juárez, Annamaria Martino, Li-Wei Lo, Cinzia Monaco, Álvaro E Reyes-Quintero, Nicolo' Martini, Tardu Oezkartal, Catherine Klersy, Josep Brugada, Peter J Schwartz, Pedro Brugada, Bernard Belhassen, Angelo Auricchio
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引用次数: 0

摘要

背景:对遗传性心律失常综合征(IAS)合并房性心律失常(AAs)患者的分布和临床病程知之甚少:方法:进行了一项国际多中心研究,涉及 16 个国家的 28 个中心。纳入标准为1)IAS;2)心电图记录有 AAs。主要终点是心脏性猝死、持续 VAs 或适当的 ICD 干预的综合结果。此外,还对脑卒中、AAs 导致的不适当 ICD 电击以及窦房结功能障碍的发生率进行了评估:共纳入了 522 名 IAS 和 AAs 患者。大多数患者被诊断为 Brugada 综合征(355 人,占 68%)和长 QT 综合征(93 人,占 18%)。其余患者(71 人,占 14%)表现为短 QT 综合征、早期复极综合征(ERS)、儿茶酚胺能多形性室性心动过速(CPVT)、进行性心脏传导疾病或特发性心室颤动。心房颤动(AF)是最常见的 AA(82%),其次是心房扑动(9%)和房性心动过速(9%)。在 52% 的患者中,房颤是 IAS 的首发临床表现。23%的患者记录有一种以上的 AA。9名患者(3%)在确诊IAS之前出现过VA,原因是服用了治疗AA的抗心律失常药物。主要终点的发病率为每年 1.4%,在 20 岁之前首次出现 AA 的患者中,发病率增加了两倍(OR 2.2,P=0.043)。这一点在不同形式的 IAS 中都是一致的。据报道,2.8%的患者因AA导致ICD不适当休克,4.4%的患者中风,9.6%的患者窦房结功能障碍:结论:在 IAS 和 AAs 患者中,约有一半的患者以 AA 为首发临床表现,四分之一的患者存在一种以上的 AAs。较早出现 AA 可能与较高的室性心律失常风险有关。中风和窦房结功能障碍在这一人群中并不罕见。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
aTrial arrhythmias in inhEriTed aRrhythmIa Syndromes: results from the TETRIS study.

Background: Little is known about the distribution and clinical course of patients with inherited arrhythmia syndrome (IAS) and concomitant atrial arrhythmias (AAs).

Aim: 1) to characterize the distribution of AAs in patients with IAS and 2) evaluate the long-term clinical course of these patients.

Methods: An international multicenter study was performed and involved 28 centers in 16 countries. Inclusion criteria were: 1) IAS and 2) ECG documentation of AAs. The primary endpoint was a composite of sudden cardiac death, sustained VAs or appropriate ICD interventions. Strokes, inappropriate ICD shocks due to AAs, and the occurrence of sinus node dysfunction were assessed.

Results: A total of 522 patients with IAS and AAs were included. Most patients were diagnosed with Brugada syndrome (n=355, 68%) and long-QT syndrome (n=93, 18%). The remaining patients (n=71, 14%) presented with short-QT syndrome, early repolarization syndrome (ERS), catecholaminergic polymorphic ventricular tachycardia (CPVT), progressive cardiac conduction diseases, or idiopathic ventricular fibrillation. Atrial fibrillation (AF) was the most prevalent AA (82%), followed by atrial flutter (9%) and atrial tachycardia (9%). AA was the first clinical manifestation of IAS in 52% of patients. More than one type of AAs was documented in 23% of patients. Nine patients (3%) experienced VA before the diagnosis of IAS, due the use of anti-arrhythmic medications taken for the AA. The incidence of the primary endpoint was 1.4% per year, with a twofold increase observed in patients who experienced their first AA before the age of 20 (OR 2.2, p=0.043). This was consistent across the different forms of IAS. Inappropriate ICD shock due to AAs were reported in 2.8% of patients, strokes in 4.4% and sinus node dysfunction in 9.6%.

Conclusions: Among patients with IAS and AAs, AA is the first clinical manifestation in about half of the cases, with more than one form of AAs present in one-fourth of the patients. The occurrence of AA earlier in life may be associated with a higher risk of ventricular arrhythmias. The occurrence of stroke and sinus node dysfunction is not-infrequently in this cohort.

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来源期刊
Europace
Europace 医学-心血管系统
CiteScore
10.30
自引率
8.20%
发文量
851
审稿时长
3-6 weeks
期刊介绍: EP - Europace - European Journal of Pacing, Arrhythmias and Cardiac Electrophysiology of the European Heart Rhythm Association of the European Society of Cardiology. The journal aims to provide an avenue of communication of top quality European and international original scientific work and reviews in the fields of Arrhythmias, Pacing and Cellular Electrophysiology. The Journal offers the reader a collection of contemporary original peer-reviewed papers, invited papers and editorial comments together with book reviews and correspondence.
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