与非缺血性患者相比,缺血性患者的不适当电击明显减少:高容量单中心S-ICD经验。

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2021-11-01 Epub Date: 2021-09-24 DOI:10.1111/pace.14364
Erik Oosterwerff, Ahmet Adiyaman, Arif Elvan, Abdul Ghani, Lennaert Hoek, Karel Breeman, Jaap Jan Smit, Anand Ramdat Misier, Peter Paul Delnoy
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引用次数: 1

摘要

背景:皮下心脏转复除颤器(S-ICD)仍然优先用于相对年轻的、不太严重的心脏病患者。目的:因此,我们研究目前报道不足的S-ICD在亚组患者中的短期和长期疗效和安全性。方法:在2010年11月至2019年2月期间,共有218例患者接受了S-ICD,并随访了至少6个月。平均随访38个月。结果:S-ICD植入最常见的适应症是缺血性心肌病(n = 106, 49%)。需要介入治疗的并发症发生率为9% (n = 21)。S-ICD患者的适宜休克率为3.5%/年。19例患者共发生30次不适当电击(IAS) (8.7%;2.7% /年)。不同心肌病患者休克率适宜与不适宜的比例差异显著。非缺血性心肌病患者的IAS显著高于缺血性心肌病患者(3.6%/年vs. 1.7%/年,p = 0.048)。多变量分析发现,除了心肌病类型外,房颤(AF)也是IAS的预测因子。结论:在这个现实世界的前瞻性注册中,我们分析了S-ICD在更传统的ICD患者中的表现。与非缺血性心肌病患者相比,缺血性心肌病患者的不适当治疗明显减少,似乎适合这种类型的装置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Significantly less inappropriate shocks in ischemic patients compared to non-ischemic patients: The S-ICD experience of a high volume single-center.

Background: The subcutaneous cardioverter-defibrillator (S-ICD) continues to be preferentially used in relatively young patients, with less advanced heart disease.

Objective: We, therefore, studied the short and long-term efficacy and safety of the S-ICD in subgroups of patients, which are underreported at present.

Methods: A total of 218 patients between November 2010 and February 2019 undergoing S-ICD with a follow up of at least 6 months implantation were included in a prospective registry. Mean follow up was 38 months.

Results: The most common indication for S-ICD implantation was ischemic cardiomyopathy (n = 106, 49%). Complication rate needing invasive intervention was 9% (n = 21). Appropriate shock rate in patients with an S-ICD was 3.5%/year. A total of 30 inappropriate shocks (IAS) occurred in 19 patients (8.7%; 2.7%/year). The proportion of appropriate and inappropriate shock rates in patients with different cardiomyopathies shows remarkable variances. There were significant more IAS (3.6%/year vs. 1.7%/year, p = .048) in patients with non-ischemic cardiomyopathy versus patients with ischemic cardiomyopathy. Multivariate analysis identified, besides type of cardiomyopathy, atrial fibrillation (AF) as predictor for IAS.

Conclusion: In this real-world prospective registry we analyzed S-ICD performance in the more traditional ICD patient. Patients with ischemic cardiomyopathy had significantly less inappropriate therapy compared to patients with non-ischemic cardiomyopathy and appear to be appropriate patients for this type of device.

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