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在老年人中进行除器交换

Henrike Andresen1, Nikolaos Pagonas1,2, Marius Eisert2

  • 1Department of Internal Medicine I, Klinikum Brandenburg, Brandenburg/Havel, Germany.

Heart rhythm O2
|June 26, 2023
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概括

植入式心脏转换器-除器 (ICD) 发生器交换结果在老年患者中显示,八十岁患者的死亡率更高. 仔细的个人评估对于老年人的ICD决定至关重要.

关键词:
发电机交易所 发电机交易所可植入的心脏转换器-除器八分生殖者 八分生殖者生活质量生活的质量.七十多岁的老人

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科学领域:

  • 心脏病学 心脏病学
  • 老年医学 老年医学
  • 医疗器械 医疗器械

背景情况:

  • 在老年患者中,植入式心脏转换器-除器 (ICD) 治疗存在临床困境,因为非失常性死亡率可能削弱存活效益.
  • 在非常老年人群中,ICD的有效性和安全性需要进一步研究.

研究的目的:

  • 评估七十岁和八十岁的人在选择性植入式心脏转换器-除器 (ICD) 发生器交换 (GE) 后的结果.
  • 为了比较这两个老年人群之间的ICD冲击的发生率和存活率.

主要方法:

  • 对506名接受选择性ICD生成器交换的患者的分析,分为七十岁 (70-79岁) 和八十岁 (≥80岁) 的患者.
  • 主要终点:所有原因的死亡率. 二级终点:适当的ICD冲击后的生存率和没有先前ICD冲击的死亡率.
  • 统计分析以确定ICD治疗,死亡率和其他临床因素之间的关联.

主要成果:

  • 在ICD发生器交换 (P < .01) 后,八岁以上的人的全因死亡率 (79%) 与七岁以上的人 (42.5%) 相比显著更高 (P < .01).
  • 在两组中,没有适当的ICD冲击 ("先前死亡") 的死亡比适当的冲击更常见.
  • 先进的心力衰竭,外围动脉疾病和功能衰竭被确定为七十岁和八十岁的死亡率的显著预测因素.

结论:

  • 植入式心脏转换器-除器 (ICD) 生成器交换器在八十岁的人中与与七十岁的人相比死亡率大幅增加有关.
  • 非节律不整的死亡原因普遍存在,这强调需要仔细考虑非常老年人的ICD治疗.
  • 在对老年人群的ICD发生器交换做出决定时,个性化患者评估至关重要.