替换S-ICD发电机的患者进行除检测:是否仍然需要?
Benedikt Biller1, Florian Reinke1, Katharina Biller2
1Department of Cardiology II - Electrophysiology, University Hospital Münster, Münster, Germany.
Pacing and clinical electrophysiology : PACE
|December 28, 2024
概括
在皮下ICD (S-ICD) 发生器更换过程中不建议省略除门 (DFT) 测试. 普雷托里安得分和高压阻抗可以预测转换失败,指导决定是否进行DFT测试.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医疗器械技术 医疗器械技术
背景情况:
- 在静脉输入植入式心脏转换器除器 (ICD) 中,可以省略手术内除门 (DFT) 测试.
- 缺少关于皮下ICD (S-ICD) 进行DFT测试的必要性的数据,特别是在发电机更换期间.
研究的目的:
- 为了评估在S-ICD发电机更换期间手术内DFT的结果.
- 在S-ICD发电机更换过程中识别转换故障的预测因素.
主要方法:
- 对112名连续接受S-ICD发电机更换和例行测试的患者进行了回顾性分析.
- 对手术内DFT结果的评估以及与患者特征,PRAETORIAN得分和高压阻抗的相关性.
主要成果:
- 在发电机更换期间,87.3%的患者在没有重大不良事件的情况下获得了成功的DFT测试.
- 与初始植入相比,PRAETORIAN得分一般较低,HV阻抗增加.
- 转换失败的风险增加了较高的PRAETORIAN风险类;PRAETORIAN得分和HV阻抗是失败的最准确的预测指标.
结论:
- 在S-ICD发电机更换期间常规省略DFT测试是不建议的.
- 使用低阻抗DFT测量和PRAETORIAN得分的新算法可以预测转换失败.
- 患有HV阻抗<70欧姆和PRAETORIAN得分<90的患者转化失败的风险非常低. 在发电机更换期间,建议在PRAETORIAN得分>150的患者进行DFT测试.
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