节拍器和ICD编程遵守基于证据的建议.
Alexander Smith1, Matthew Ortman1, John Andriulli1
1Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Journal of cardiovascular electrophysiology
|January 10, 2026
概括
尽管有专家的指导方针,最佳的起器和ICD编程仍然是一个挑战. 这项研究发现,在指导方针更新后,遵守共识建议的情况没有改善,这突显了指导方针与实践之间的差距.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 临床实践指南 临床实践指南
背景情况:
- 对于心脏起器 (PPM) 和 implantable cardioverter-defibrillator (ICD) 编程的专家共识指南已经存在.
- 在现实世界中,对这些数据驱动的建议的坚持往往不够理想.
- 在推和实际的设备编程实践之间仍然存在差距.
研究的目的:
- 评估2015年专家共识指南对心脏起器和ICD编程的遵守情况.
- 为了确定共识声明更新后是否有所改善.
- 在指南实施之前和之后分析设备编程数据.
主要方法:
- 设备植入物注册数据的回顾性,观察性,单中心研究.
- 单体,双体或双心 (BiV) 设备的比较编程参数在 (2012-2013) 之前和之后 (2020-2022) 达成共识.
- 评估BiV节奏百分比 (>98%) 和ICD胸/心律不整的设置 (仅限Medtronic设备).
主要成果:
- 经过共识后,双管节律调节的坚持率下降 (85.4%至58.0%为>98%的节律调节).
- 国际心脏病诊断中心心节律调节的坚持仍然相似 (89.5%与90.1%).
- 观察到一个趋势,即改善了心律不规律的坚持 (39.5%与45.7%相比),如果排除了SVT逻辑,则显著增加.
结论:
- 在现实世界中,对心脏起器和ICD编程指南的坚持显示了持续的断开.
- 目前的临床实践并不完全符合基于数据的建议.
- 需要进一步的研究来了解医生对指南实施的障碍.
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