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DREAM-ICD-II研究について

Christian Steinberg¹, Nicolas Dognin¹, Amit Sodhi^2,3

¹Institut universitaire de cardiologie et pneumologie de Québec, Quebec, Canada (C.S., N.D., C.C., J.C., J.-F.S., B.P., K.R., L.B., I.N., G.O., F.P.).

|December 16, 2021

まとめ

この要約は機械生成です。

二次予防埋め込み式心動除細動器 (ICD) の導入後の運転制限は,安全に3ヶ月まで短縮することができます. ICDを挿入した最初の3ヶ月後,心室動脈不全に対するデバイス治療のリスクは著しく低下します.

キーワード:

突然の心臓発作による死亡インプラント式除細動器運転制限二次予防静脈動脈不調,心臓病

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科学分野:

心臓病科
医療機器
公衆衛生

背景:

現在のガイドラインでは,二次予防後の6ヶ月の運転制限を推奨しています. インプラント可能な心臓変圧器 (ICD) のインプラント.
これらの制限は患者にとって大きな不便と社会的影響を及ぼします.

研究の目的:

現代の二次予防ICD患者における適切なデバイス治療の発生率を評価する.
現在の運転制限ガイドラインの安全性と有効性を評価する.

主な方法:

新しい二次予防ICDインプラントを受けた721人の患者を対象とした遡及研究.
カナダの3つの高等保健センターでの追跡期間の中央値は760日 (2016-2020年).

主要な成果:

最初の3ヶ月 (34. 4%) で最大で,その後は著しく減少した.
適切な治療の100患者日あたりの発生率は90日後の0. 48から365日後の0. 21に減少した (P< 0. 001).
急性心不全の累積発生率は90日間の1. 8% から91~180日間の0. 4% に低下した (P< 0. 001).

結論:

適切な治療と突然の心不全の発生率は,以前報告されたより低く,3ヶ月後に大幅に減少しています.
ICDの挿入後3ヶ月まで運転制限を減らすことは安全であるようです.
二次予防 ICDの導入後の運転制限に関する既存のガイドラインは,再検討されるべきである.