DREAM-ICD-II研究
Christian Steinberg1, Nicolas Dognin1, Amit Sodhi2,3
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.).
Circulation
|December 16, 2021
概括
在二次预防植入式心动除器 (ICD) 植入后的驾驶限制可以安全地减少到3个月. 在ICD插入后的最初3个月后,心室节律失常治疗的风险显著降低.
科学领域:
- 心脏病学
- 医疗器械
- 公共卫生
背景情况:
- 目前的指导方针建议在二级预防后实施6个月的驾驶限制.
- 这些限制对患者造成重大不便和社会影响.
研究的目的:
- 在当代二次预防ICD患者中评估适当设备治疗的发病率.
- 评估当前驾驶限制指南的安全性和有效性.
主要方法:
- 这是一项涉及721名接受了新的二次预防ICD植入物的回顾性研究.
- 在加拿大3个第三级护理中心 (2016-2020年) 中,随访时间中位数为760天.
主要成果:
- 腹腔失常的风险在前3个月 (34. 4%) 最高,随后显著下降.
- 适当治疗的发病率从90天的0. 48下降到365天的0. 21 (P< 0. 001).
- 突然心力衰竭的累积发病率从90天内的1. 8%降至91至180天的0. 4% (P< 0. 001).
结论:
- 适当治疗和突然心力衰竭的发生率低于之前报告的,并在3个月后大幅下降.
- 在ICD植入后将驾驶限制降至3个月似乎是安全的.
- 应重新考虑二次预防ICD植入后驾驶限制的现有指导方针.
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