心律失常与起搏领域临床研究2023年度进展Progress of clinical research in arrhythmias and pacing 2023
吴寸草,李学斌
摘要(Abstract)：
回顾2023年心律失常领域重要临床试验，涉及心房颤动（房颤）、起搏等方面。CIRDADOSE研究及EARLY-AF研究均肯定冷冻球囊消融治疗房颤疗效，减慢房颤进展。MANIFEST-PF研究回顾房颤脉冲场消融的成功率及安全性，在ADVENT研究中再次证实其安全性和有效性不劣于传统热消融。在左束支区域起搏（LBBAP）研究中，与双心室起搏（BVP）相比，LBBAP降低持续性室性心动过速（VT）/心室颤动（VF）和新发房颤发生率。对于起搏比例高且射血分数降低的起搏器或植入式心律转复除颤器（ICD）患者，BUDAPEST CRT升级研究肯定了其升级到心脏再同步除颤器（CRT-D）的明确获益。DANPACEⅡ研究显示窦房结功能障碍患者的心房起搏最小化并不能降低房颤的发生率。IDE研究显示Aveir DR双腔无导线起搏器术后3个月安全性良好，可提供可靠的心房起搏和房室同步。iSUSI研究是对皮下植入式心律转复除颤器的注册研究，发现心力衰竭和非心力衰竭患者不恰当和恰当电击率相似。
关键词(KeyWords)： 临床试验;心房颤动;冷冻球囊消融;脉冲场消融;左束支区域起搏;CRT升级;无导线起搏器;植入式除颤器
基金项目(Foundation):
作者(Author): 吴寸草,李学斌
参考文献(References)：
- [1]Andrade JG,Deyell MW,Khairy P,et al.Atrial fibrillation progression after cryoablation versus radiofrequency ablation:the CIRCA-DOSE trial[J].Eur Heart J,2023:ehad572.DOI:10.10 9 3/eurheartj/ehad572.
- [2]Andrade JG,Deyell MW,Macle L,et al.Progression of atrial fibrillation after cryoablation or drug therapy[J].N Engl J Med,2023,388(2):105-116.DOI:10.1056/NEJMoa2212540.
- [3]Turagam MK,Neuzil P,Schmidt B,et al.Safety and effectiveness of pulsed field ablation to treat atrial fibrillation:one-year outcomes from the MANIFEST-PF registry[J].Circulation,2023,148(1):35-46.DOI:10.1161/CIRCULATIONAHA.123.064959.
- [4]Reddy VY,Gerstenfeld EP,Natale A,et al.Pulsed field o r conventional thermal ablation for paroxysmal atrial fibrillation[J].N Engl J Med,2023,389(18):1660-1671.DOI:10.1056/NEJMoa2307291.
- [5]Herweg B,Sharma PS,Cano 6,et al.Arrhythmic risk in biventricular pacing compared with left bundle branch area pacing:results from the international LBBAP collaborative study(I-CLAS)[J].Circulation,2024,149(5):379-390.DOI:10.1161/CIRCULATIONAHA.123.067465.
- [6]Merkely B,Hatala R,Wranicz JK,et al.Upgrade of right ventricular pacing to cardiac re synchronization therapy in heart failure:a randomized trial[J].Eur Heart J,2023,44(40):4259-4269.DOI:10.1093/eurheartj/ehad591.
- [7]Kronborg MB,Frausing MHJP,Malczynski J,et al.Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation:a randomized trial[J].Eur Heart J,2023,44(40):4246-4255.DOI:10.1093/eurheartj/ehad564.
- [8]Knops RE,Reddy VY,Ip JE,et al.A dual-chamber leadless pacemaker[J].N Engl J Med,2023,388(25):2360-2370.DOI:10.1056/NEJMoa2300080.
- [9]Petek BJ,Churchill TW,Moulson N,et al.Sudden cardiac death in national collegiate athletic association athletes:a 20-year study[J].Circulation,2024,149(2):80-90.DOI:10.1161/CIRCULATIONAHA.123.065908.
- [10]Schiavone M,Gasperetti A,Laredo M,et al.Inappropriate shock rates and long-term complications due to subcutaneous implantable cardioverter defibrillators in patients with and without heart failure:results from a multicenter,international registry[J].Circ Arrhythm Electrophysiol,2023,16(1):e011404.DOI:10.1161/CIRCEP.122.011404.