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与植入式心脏转换器-除器替换相关的并发症,以响应设备建议
Paul A Gould1, Andrew D Krahn,
1Division of Cardiology, Department of Medicine, University of Western Ontario, London.
JAMA
|April 28, 2006
概括
植入式心脏转换器-除器 (ICD) 发电机因咨询而被更换,其并发症率很高,包括死亡. 这强调了需要制定新的指导方针来管理具有咨询性ICD的患者.
科学领域:
- 心脏病学 心脏病学
- 医疗器械安全 医疗器械安全
- 电力生理学 电力生理学
背景情况:
- 最近的植入式心动除器 (ICD) 咨询和召回给医生带来了管理挑战.
- 对于目前咨询性ICD的管理策略,目前还没有具体的指导方针或结果数据.
- 在这个人群中,ICD发电机更换的并发症风险仍未评估.
研究的目的:
- 为了确定与ICD发电机更换相关的并发症率,专门针对当前的ICD建议.
- 为制定咨询性ICD患者的管理指南提供数据.
主要方法:
- 对17个加拿大ICD植入中心进行了调查.
- 在2004年10月至2005年10月期间,收集了因咨询意见而导致的选择性ICD发电机更换并发症率的数据.
- 在发电机更换后的随访期间追踪并发症.
主要成果:
- 在533名被替换ICD的患者中,8.1%的患者出现并发症.
- 需要重新手术的重大并发症发生在5.8%的患者中,有2例因口袋感染而死亡.
- 在2.3%的患者中观察到轻微并发症.
结论:
- 在具有咨询设备的患者中,ICD发电机更换与严重的并发症率有关,包括死亡率.
- 这些发现强调了在制定咨询性ICD治疗指南时需要考虑并发症风险的必要性.
- 需要进一步的研究,以建立最佳的管理策略,为患者召回或咨询ICDs.
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