JAHA:单、双腔植入式心律转复除颤器不合理放电和其他健康结局的比较

2017-11-13 xiangting MedSci原创

在无起搏指征、接受初级预防ICD的患者中,与单腔装置相比,双腔装置与不合理放电风险较低或住院、死亡的差异无相关性。

在美国的临床实践中,许多接受植入式心律转复除颤器(ICD)用于心源性猝死初级预防的患者使用双腔装置。双腔装置相对于单腔在降低临床不合理ICD放电风险上的优势尚不明确。这项研究的目的是比较用于初级预防的单腔和双腔ICD不良结局的风险,其中包括不合理放电。

从2006年至2009年植入式心律转复除颤器纵向研究中7个综合医疗系统的15家医院,确定了接受初级预防单腔或双腔ICD而没有起搏指征的患者。主要结局是出现首次不合理放电的时间。ICD放电被判定为合适的。其他结局包括全因住院、心衰住院和死亡。采用倾向评分加权法对患者、临床医生和医院水平的因素进行计算。在1042例无起搏指征的患者中,54.0%(563例)接受了单腔装置,46.0%(479例)接受了双腔装置。在倾向加权分析中,设备类型与不合理放电(危险比,0.91; 95%置信区间,0.59-1.38 [ P = 0.65]),全因住院(危险比1.03; 95%置信度间隔0.87-1.21 [ P = 0.76]),心衰住院(危险比0.93,95%可信区间0.72-1.21 [ P= 0.59])或死亡(风险比,1.19; 95%置信区间,0.93-1.53 [ P = 0.17])不相关。

在无起搏指征、接受初级预防ICD的患者中,与单腔装置相比,双腔装置与不合理放电风险较低或住院、死亡的差异无相关性。这项研究说明没有理由使用双腔装置来减少不合理放电。

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    2018-02-17 villahu
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    2017-11-15 zhaohui6731
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    2017-11-15 zhouqu_8
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    2017-11-15 jiyangfei
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    2017-11-13 131****1460

    学习了受益匪浅

    0

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