V5和/或V6导联术后S波预测左束支区起搏心力衰竭患者更好的临床预后

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-10-01 Epub Date: 2025-08-25 DOI:10.1111/pace.70031
Kailun Zhu, Chen He, Haojie Zhu, Chuangshi Wang, Xiaofei Li, Xiaohan Fan
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引用次数: 0

摘要

背景:V5/6导联中的S波被报道为左束支(LBB)捕获成功的标志。本研究旨在评价V5/6导联S波在预测左束区起搏(LBBAP)治疗心力衰竭(HF)患者长期临床预后中的价值。方法:前瞻性纳入连续接受LBBAP治疗的HF患者,随访至少2年。分析心电图,确定V5/6导联S波。复合终点为全因死亡率、HF住院率和恶性室性心律失常。结果:共纳入57例患者,平均年龄(59.90±12.57岁),男性39例(68.42%)。38例患者出现V5/6段S波。在平均随访29.84±12.51个月期间,Kaplan-Meier曲线显示V5/6的复合终点风险降低77.8%,S (HR 0.222; 95% CI 0.065, 0.756; log-rank, p = 0.0069)。多因素Cox回归分析显示,V5/6合并S与复合终点的风险降低69.0%(校正HR 0.31; 95% CI 0.09, 1.05; p = 0.041)。V5/6伴S组无有效率为22.58%,V5/6无S组无有效率为58.82% (p = 0.012)。结论:LBBAP后V5和/或V6导联S波预测临床预后较好,且LBBAP对HF患者CRT治疗的有效率较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Postoperative S Wave in Lead V5 and/or V6 Predicts Better Clinical Outcomes in Heart Failure Patients With Left Bundle Branch Area Pacing.

Background: S wave in lead V5/6 has been reported as a marker indicated for successful left bundle branch (LBB) capture. This study aimed to evaluate the value of the S wave in lead V5/6 in predicting the long-term clinical outcomes in heart failure (HF) patients treated with left bundle area pacing (LBBAP).

Methods: Consecutive HF patients receiving LBBAP were prospectively enrolled and followed at least 2 years. ECG were analyzed to identify the S wave in lead V5/6. The composite end point was all-cause mortality, HF hospitalization, and malignant ventricular arrhythmias. Non-response to LBBAP delivered cardiac resynchronization therapy (CRT) was defined as left ventricular ejection fraction improvement <5% at 6 months after implantation.

Results: A total of 57 patients were included with the mean age of 59.90 ± 12.57 years and 39 (68.42%) males. S wave in V5/6 was observed in 38 patients. During a mean follow up of 29.84 ± 12.51 months, Kaplan-Meier curves showed a 77.8% reduction in risk of composite end point for V5/6 with S (HR 0.222; 95% CI 0.065, 0.756; log-rank, p = 0.0069). Multivariate Cox regression analysis revealed that V5/6 with S was associated with a lower risk of the composite end point by 69.0% (adjusted HR 0.31; 95% CI 0.09, 1.05; p = 0.041). The non-response rate of LBBAP was 22.58% in V5/6 with S and 58.82% in V5/6 without S (p = 0.012).

Conclusion: S wave in lead V5 and/or V6 after LBBAP predicts better clinical outcomes, and has a better response rate of LBBAP for CRT in HF patients.

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