在儿童中植入心脏转换器-除器:一个为期14年的基于人口的研究
Marko Bjeloševič1,2, Peter Olejník1,3, Jaroslav Tomko2
1Department of Paediatric Cardiology, Faculty of Medicine Comenius University in Bratislava Bratislava Slovakia.
Journal of arrhythmia
|March 11, 2026
概括
儿科植入式心脏转换器-除器 (ICD) 的使用显示出严重的并发症,特别是在初级预防中. 较新的皮下 (S-ICD) 和血管外 (EV-ICD) 系统为儿童提供了有希望的,不那么侵入性的替代方案.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 医疗器械技术 医疗器械技术
- 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) 治疗儿童,特别是用于初级预防,数据有限,特别是来自较不富裕的地区.
- 全皮下 (S-ICD) 和外血管 (EV-ICD) 系统的日益普及,需要对其在儿科患者群体中的使用进行分析.
研究的目的:
- 分析儿科ICD接受者的流行病学,指示,并发症和结果.
- 评估不同类型的ICD系统对儿童的安全性和有效性.
- 评估初级预防风险分层对儿科ICD植入的挑战.
主要方法:
- 一个回顾性,基于人口的,全国性的,单一中心的研究,分析了2012年至2025年的医疗记录.
- 包括0-18岁接受ICD植入的患者.
- 卡普兰-梅尔对无冲击和死亡终点的分析.
主要成果:
- 包括49名儿科患者,估计全国发病率为每22,000名活产婴儿中1例ICD植入.
- ICD主要用于二次预防 (80%),长QT综合征和多变性心肌病是常见的诊断.
- 在27%的二次预防患者中发生了适当的冲击;尽管死亡率较高,但在初级预防中没有看到适当的治疗方法. 不适当的冲击影响了22%,主要的设备并发症发生在17%.
结论:
- 儿科ICD治疗与与设备相关的显著发病率和初级预防风险分层方面的挑战有关.
- 新兴的S-ICD和EV-ICD系统显示出对选定的儿科患者具有较少侵入性的替代方案.
- 需要进一步的研究来优化ICD治疗和儿童群体的风险分层.
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