植入式心脏转换器-除器治疗用于初级和二级预防的比较和预测因素
Reinder Evertz1, Tessa van der Heijden2, Rypko Beukema2
1Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands. reinder.evertz@radboudumc.nl.
概括
与初级预防相比,接受植入式心脏转换器-除器 (ICD) 进行二次预防的患者面临更高的治疗风险. 然而,两组之间不良事件,住院和死亡率仍然相似.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 植入式心脏转换器-除器 (ICD) 对于管理心室节律失常至关重要.
- 有限的数据存在于ICD治疗预测因子和不同患者适应症的结果.
- 这项研究调查了基于预防指示和心脏病理学的ICD治疗发生率和类型.
研究的目的:
- 分析在接受初级预防和二级预防的患者中ICD治疗的发生率和类型.
- 为了确定适当的ICD治疗的预测因素.
- 为了比较两个预防组之间的不良事件,心血管住院和全因死亡率.
主要方法:
- 在一个中心对482名患者进行了回顾性观察性研究.
- 在2015-2020年期间,患者接受了ICD植入用于初级 (53.3%) 或二级 (46.7%) 预防.
- 随访时间中位数为2.4年.
主要成果:
- 适当的ICD治疗发生在9.7%的初级患者和27.6%的二级预防患者中 (p < 0.001).
- 在二次预防组中,第一个适当的ICD治疗的时间显著缩短 (p < 0.001).
- 男性性别和二次预防指示预测了适当的ICD治疗. 静脉动脉冲动 (VT) 是治疗的最常见原因 (70%).
结论:
- 二次预防患者具有更高的风险和更短的时间来进行首次适当的ICD治疗.
- 组之间,并发症率,心血管住院和全因死亡率是可比的.
- 未来的战略应侧重于预防ICD治疗,特别是复发性静脉治疗.
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