在心脏植入式电子设备放置后使用直接口服抗凝剂

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Updated: Sep 13, 2025

28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.5K

Carmel Ashur¹, Li Qin², Karl E Minges²

¹Division of Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA.

Pacing and clinical electrophysiology : PACE

|July 31, 2025

概括

在心脏植入式电子设备 (CIED) 放置后,超过一半的心房动 (AF) 患者被处方直接口服抗凝剂 (DOAC),随着时间的推移,使用量增加. 虽然DOAC使用显示出血瘤风险略高,但与中风率降低有关.

科学领域:

心脏病学心脏病学
药理学药理学是指药理学的学科.

背景情况:

有限的数据存在于直接口服抗凝剂 (DOAC) 在心房 (AF) 患者接受心脏植入式电子设备 (CIED) 放置的使用.
在这个人群中,不间断的DOAC治疗的现实实践模式和结果还没有得到很好的定义.

研究的目的:

描述AF患者无并发症,门诊CIED植入后DOAC使用的趋势.
评估与出院时的DOAC状态相关的临床结果.

主要方法:

使用了国家心血管数据注册表的AF患者数据 (CHA ₂ DS ₂ -VASc ≥2) 进行无并发症的门诊CIED安置 (2016年4月至2019年12月).
根据出院时的DOAC处方分层患者,并使用医疗保险和医疗补助中心 (CMS) 索赔数据评估结果.

主要成果:

在59,169名符合条件的AF患者中,54.1%的患者通过DOAC出院,每年出院率从47.0% (2016) 增加到62.5% (2019).
在30天后,DOAC使用与更高的口袋血瘤 (0.51%对比0.33%) 和更低的中风率 (2.9%对比3.2%) 相关.
两组之间没有观察到30天或1年后设备感染或修订率的显著差异.

结论:

在接受CIED植入的AF患者中,大约有一半的患者在DOAC中出院,并观察到日益增加的趋势.
使用DOAC与口袋血瘤和设备修订率的适度增加有关,但与设备感染的风险相似.

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