现代植入式心脏转换器-除器的好处:在一个大规模的现实世界队列中,时间到第一次治疗
Anne B Curtis1, Angelo Auricchio2, Suneet Mittal3
1Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
JACC. Clinical electrophysiology
|August 13, 2025
概括
几乎有一半的植入式心脏转换器-除器 (ICD) 患者在10年内接受适当的治疗. 这证实了ICD在预防心脏突发死亡方面的持续益处.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电子生理学 电子生理学
背景情况:
- 植入式心脏转换器-除器 (ICD) 对于降低患有心脏突然死亡风险的患者的死亡率至关重要.
- 心力衰竭管理方面的进展可能会影响ICD疗法的利用和有效性.
- 在当代患者群体中对ICD益处进行最新评估是有必要的.
研究的目的:
- 为了评估当前ICD接受者的第一次治疗的时间.
- 通过判断数据估计适当的ICD疗法的比例.
- 根据初级与二级预防指示分析治疗发生率.
主要方法:
- 对237,627个单室或双室ICD接收者的非识别数据库 (Medtronic CareLink,2013-2024) 的分析.
- 对冲击,抗心动节拍 (ATP) 和任何治疗的累积发病率曲线的生成.
- 手动评判595个随机选择的情节,以评估治疗的适当性,并将结果推断到整个队列.
主要成果:
- 第一次适当的冲击,ATP或任何治疗的10年累计发病率分别为33%,42%和48%.
- 与初级预防患者相比,接受ICD二次预防的患者的适当治疗率较高 (例如,在10年后第一次适当的休克时,41%vs32%).
- 男性患者占研究人口的71.8%.
结论:
- 大约48%的当代患者在植入后10年内接受适当的ICD治疗.
- 这些发现强调了ICD的持续临床益处,即使在心脏护理和设备管理方面取得了进展.
- ICD仍然是管理患有突然心脏病死亡风险的患者的重要工具.
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