植入式心脏转换器-除器用于亚洲的初级预防
Arwa Younis1, Bruce L Wilkoff2
1Cardiac Electrophysiology and Pacing Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: https://twitter.com/arwayounis2.
JACC. Asia
|June 16, 2023
概括
鉴定患者需要植入式心脏转换器-除器 (ICD) 用于初级预防突然心脏死亡 (SCD) 是一个挑战. 本次审查旨在改善ICD患者选择,特别是在亚洲等利用不足的地区.
科学领域:
- 心脏病学 心脏病学
- 医疗技术 医疗技术 医学技术
- 公共卫生 公共卫生
背景情况:
- 突发心脏病死亡 (SCD) 的风险在当代环境中很低,由于心力衰竭的改善管理和先进的技术而复杂化.
- 亚洲和西方国家在植入式心脏转换器-除器 (ICD) 使用方面存在显著差异,尽管亚洲的SCD患病率较低.
- 在资源有限的地区,ICD的不足利用需要针对SCD初级预防的量身定制方法.
研究的目的:
- 审查目前关于ICD治疗用于SCD初级预防的知识.
- 确定优化ICD植入患者和设备选择的策略.
- 解决ICD使用的挑战,特别是在亚洲人口和资源有限的环境中.
主要方法:
- 对SCD预防ICD治疗当前研究的文献综述.
- 对全球SCD流行率和ICD使用率的流行病学数据的分析,重点是亚洲.
- 讨论影响ICD患者和设备选择的因素.
主要成果:
- 鉴定初级预防ICD的最佳候选者仍然是一个挑战,因为事件率低和先进疗法.
- 与西方国家 (∼45%) 相比,亚洲 (∼12%) 的ICD使用率明显不足.
- 区域差异和有限的资源导致了ICD使用的差距,突出了对个性化策略的需求.
结论:
- 个性化方法对于选择患者至关重要,这些患者将受益于ICD用于SCD初级预防.
- 需要具体的区域性建议来解决ICD的不足利用问题,特别是在亚洲.
- 改善患者和设备选择是优化ICD治疗在各种医疗保健环境中SCD预防的关键.
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