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目的 探讨心脏电生理平衡指数（iCEB）对起搏器置入术后新发心房高频事件（AHREs）的预测价值。方法 回顾性选取2019年5月至2023年11月于本院初次接受双腔永久性起搏器手术治疗的患者为研究对象，均接受术后随访1年，根据随访期间是否发生AHREs分为AHREs组和非AHREs组。比较两组的基本信息、实验室检查、超声心动图和心电图检查等资料，计算iCEB并绘制受试者操作特征（ROC）曲线分析其对AHREs的预测价值。结果 初步纳入139例患者，排除15例（失访9例，资料不完整6例），最终纳入124例。随访时间14(10,39)月，随访期间34例发生AHREs，占比27.42%。与非AHREs组相比，AHREs组年龄和左心房内径（LAD）更大，心房起搏比例（AP）和iCEB更高（P均<0.05）。多因素Logistic回归分析显示，LAD、AP、iCEB是起搏器置入术后发生AHREs的独立危险因素（P<0.05）。相关性分析显示，AHREs组患者iCEB值与AHREs持续时间呈正相关关系（r=0.427,P<0.05）。ROC曲线结果显示，iCEB预测起搏器置入术后新发AHREs的ROC曲线下面积（AUC）为0.910(95%CI:0.856～0.965)，最佳截断值为4.125，灵敏度88.20%，特异度82.20%，约登指数为70.40%。结论 iCEB对起搏器置入术后新发AHREs具有良好的预测价值，对于iCEB≥4.125的患者，需要更早地进行电生理评估和干预以预防AHREs的发生。
Abstract：Objective To investigate the predictive value of cardiac electrophysiological balance index(iCEB) on new-onset atrial high-rate episode( AHREs) after pacemaker implantation. Methods Patients who underwent dualchamber permanent pacemaker implantation for the first time in our hospital from May 2019 to November 2023 were retrospectively enrolled. All patients were followed up for 1 year. According to whether AHREs occurred during the follow-up period, they were divided into AHREs group and non-AHREs group. The basic clinical information, laboratory data, echocardiography, and electrocardiogram data of the two groups were compared. The iCEB was calculated and the receiver operating characteristic(ROC) curve was drawn to analyze its predictive value for AHREs. Results 139 patients were initially enrolled, 15 cases were excluded(9 cases were lost during follow-up, 6 cases with incomplete data), and 124 cases were finally included. The median follow-up time was 14(10,39) months. During the follow-up period, 34 cases of AHREs occurred, accounting for 27.42%. Compared with the non-AHREs group, the age of the AHREs group was significantly higher, left atrium diameter(LAD) was significantly larger, the percentage of atrial pacing(AP%) and iCEB were significantly higher(all P<0.05). Multivariate Logistic regression analysis showed that LAD, AP and iCEB were independent risk factors for AHREs after pacemaker implantation(P<0.05). The results of correlation analysis showed that the iCEB value of patients in the AHREs group was positively correlated with the duration of AHREs(r=0.427,P<0.05). The results of ROC curve showed that the area under ROC curve of iCEB in predicting new AHREs after pacemaker implantation was 0.910(95% CI 0.856-0.965), the optimal cut-off value was 4.125, the sensitivity was 88.20%, the specificity was 82.20%, and the Youden index was 70.40%. Conclusion iCEB has a good predictive value for new AHREs after pacemaker implantation. For patients with iCEB≥4.125, electrophysiological assessment and intervention should be performed earlier to prevent the occurrence of AHREs.
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基本信息:
中图分类号:R541.75
引用信息:
[1]孙克陆,王景武,徐敏,等.心脏电生理平衡指数对起搏器置入术后新发心房高频事件的预测价值[J].中国心脏起搏与心电生理杂志().
2025-06-24
2025-06-24
2025-06-24