Proclemer Alessandro, Ghidina Marco, Cicuttini Gloria, Gregori Dario, Fioretti Paolo Maria
Division of Cardiology, Department of Cardiovascular Sciences, S. Maria della Misericordia Hospital, Udine, Italy.
Pacing Clin Electrophysiol. 2006 Dec;29 Suppl 2:S20-8. doi: 10.1111/j.1540-8159.2006.00487.x.
Several trials demonstrated the lifesaving role of implantable cardioverter-defibrillator (ICD) in high-risk groups of patients. Aim of this review was to report the clinical characteristics of patients enrolled in the ICD Registry of the Italian Association of Arrhythmology (AIAC) in the years 2001-2004.
The Registry collects prospectively 85% of national ICD implantation activity on the basis of European ICD form (EURID).
The number of implanted ICDs in Italy was 2,418 in the year 2001, 3,992 in the year 2002, 5,595 in the year 2003, and 7,190 in the year 2004. The number of ICDs per million of inhabitants was 42.1 in the year 2001 (+11.8% respect to 2000), 70.0 in the year 2002 (+65.1% respect to 2001), 98.3 in the year 2003 (+40.4% respect to 2002), and 125.0 in the year 2004 (+27.2% respect to 2003). The median age was 67 years in the years 2001-2002, 68 years in the years 2003-2004. The main indications during the study were syncope (24.2-14.9%) and cardiac arrest (28.5-17.3%), followed by palpitations and dizzy spells (15.5-17.2%, and 9.4-6.9% of patients, respectively). The use of prophylactic ICD had a fourfold increase in the examined period (5.8% in 2001, 22.9% in 2004). Ventricular tachycardia was the main arrhythmic indication in 44.4-54.6% of cases, ventricular fibrillation in 11.8-18.0%, both in 3.5-6.5%. In the years 2002, 2003, and 2004 single chamber ICDs were implanted in 45.5%, 38.8%, and 33.7% of patients, dual chamber ICDs in 35.1%, 32.3%, and 30.5%, biventricular ICDs in 19.4%, 28.9%, and 34.7%, respectively.
The ICD implantation rate in Italy increased significantly in the period 2001-2004, similarly to the trend in other western countries. The Registry showed an important increase of prophylactic and dual or triple chamber ICDs use.
多项试验证明了植入式心脏复律除颤器（ICD）在高危患者群体中的救命作用。本综述的目的是报告2001年至2004年期间意大利心律协会（AIAC）ICD注册研究中纳入患者的临床特征。
该注册研究基于欧洲ICD表格（EURID）前瞻性收集全国85%的ICD植入活动数据。
2001年意大利植入ICD的数量为2418台，2002年为3992台，2003年为5595台，2004年为7190台。每百万居民中ICD的数量在2001年为42.1台（相较于2000年增加11.8%），2002年为70.0台（相较于2001年增加65.1%），2003年为98.3台（相较于2002年增加40.4%），2004年为125.0台（相较于2003年增加27.2%）。2001 - 2002年的中位年龄为67岁，2003 - 2004年为68岁。研究期间的主要适应证为晕厥（24.2% - 14.9%）和心脏骤停（28.5% - 17.3%），其次是心悸和头晕发作（分别占患者的15.5% - 17.2%和9.4% - 6.9%）。在研究期间预防性ICD的使用增加了四倍（2001年为5.8%，2004年为22.9%）。室性心动过速是44.4% - 54.6%病例的主要心律失常适应证，室性颤动为11.8% - 18.0%，两者均为3.5% - 6.5%。在2002年、2003年和2004年，分别有45.5%、38.8%和33.7%的患者植入单腔ICD，35.1%、32.3%和30.5%的患者植入双腔ICD，19.4%、28.9%和34.7%的患者植入双心室ICD。
2001年至2004年期间意大利的ICD植入率显著增加，与其他西方国家的趋势相似。该注册研究显示预防性以及双腔或三腔ICD的使用有显著增加。
