生理性起搏的循证医学演示教学.pptVIP

谢谢！ How serendipitous for this to have been published just weeks ago. We couldn’t get a better advocate for minimizing unnecessary RV pacing – this is the AHA’s stamp of approval for MVP. Anyone who is out there discussing minimizing RV pacing with their customers needs this in their hands and really emphasizing the need to not just reduce, but rather to MINIMIZE unnecessary RV pacing. Reprints are on the way, but the PDF and speaking points are already posted. Sweeney, et al. retrospectively studied the cumulative percent of ventricular pacing and the associated relative risk for developing new onset AF. The best models demonstrated a linearly increasing risk of AF with Cum%VP in DDDR and VVIR modes up to approximately 80-85%. The magnitude of increased risk was approximately 1% for each 1% increase in Cum%VP, and was similar between pacing modes. Key take-away: The rates of AF increased in both the DDDR and VVIR pacing modes. The overall rate of AF was slightly higher in the VVIR group. In the DDDR group the risk of AF increased by 1% for each 1% increase in cumulative %VP (up to 85%). MVP：Managed Ventricular Pacing SAVE PACe （ The Search AV Extension and Managed Ventricular Pacing for Promoting Atrioventricular Conduction ） MVP：Managed Ventricular Pacing 试验经过中期分析发现，对于发生持续性房颤的风险性，没使用减少右室起搏功能的病人比那些使用这种功能的病人高１．８倍。这具有很高的显著性差异。所以，试验被数据监管委员会提前终止。该项研究的作者发现，在应用了最小化心室起搏策略的病人组中，持续性房颤的发生风险下降了约４０％。 Kaplan-Meier estimates of time to persistent atrial fibrillation demonstrated absolute reductions in the rates of persistent atrial fibrillation associated with dual chamber minimal ventricular pacing vs. conventional dual chamber pacing of 3.85% at 1 year (95 percent confidence interval, 0.42% - 7.28%), 6.91% at 2 years (95 percent confidence interval, 2.41% - 11.41%), and 7.05% at 3 years (95 percent confidence interval, -0.30% - 14.39%)(Figure 2). The time to first cardioversion, atrioventricular nodal ablation or pulmonary vein isolation showed a difference