ペースメーカーとICDジェネレーターの故障:食品医薬品局の年次報告書の分析
William H Maisel1, Megan Moynahan, Bram D Zuckerman
1Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass 02215, USA. wmaisel@bidmc.harvard.edu
JAMA
|April 28, 2006
まとめ
ペースメーカーとインプラント可能な心臓変容器-除細動器 (ICD) の故障は数千人に影響し,ペースメーカーの信頼性が向上しています. しかし,ICDの故障率は,後の数年で大幅に増加し,デバイスのパフォーマンスの継続的なモニタリングの必要性を強調しました.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
- 医療機器の分析 医療機器の分析
背景:
- ペースメーカーとインプラント可能な心臓変容器-除細動器 (ICD) は,高リスク患者の死亡率を低減するために不可欠です.
- ますます複雑な心臓器具の信頼性は,依然として調査の分野です.
研究 の 目的:
- 米国食品医薬品局 (FDA) のペースメーカーとICDの承認後の報告書を分析する.
- デバイスの故障率の動向を特定し,全体的なパフォーマンスを評価する.
主な方法:
- 1990年から2002年にかけてのペースメーカーとICDに関するFDAの年次報告書のレビュー.
- 確認された発電機の故障とエクスプロンテーションデータの分析.
- 1000個のインプラントにつき1年間の機能障害交換率の計算.
主要な成果:
- 確認された故障により,1万7千台以上のペースメーカーとICD装置が検査されました.
- ペースメーカーの機能不全率は,研究期間中に著しく減少した.
- ICDの機能不全率は,最初は減少したが,研究の後半には著しく増加し,ペースメーカーよりも著しく高かった.
- バッテリー/コンデンサの問題と電気の問題が,デバイスの故障の主な原因でした.
結論:
- 何千人もの患者がペースメーカーとICDの機能不全を経験し,慎重にモニタリングする必要がありました.
- ペースメーカーの信頼性が向上した一方で,ICDの機能不全の増加傾向は注意が必要です.
- 生命を救う効果があるにもかかわらず,心臓器具のパフォーマンスの継続的な監視は不可欠です.
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