VDD 模式起搏治疗晚期房室传导阻滞患者的长期随访：一项初步研究。

Long-term follow-up of patients paced in VDD mode for advanced atrioventricular block: a pilot study.

作者信息

Busacca Paolo, Gheller Giuliano, Pupita Mauro, Berzigotti Giovanni, Generali Carlo Alberto, De Crescentini Sandro, Gerardi Paolo, Agostini Alberto, Frattini Claudio, Corbucci Giorgio, Papi Stefano

机构信息

Division of Cardiology-Intensive Care Unit, S. Maria della Misericordia Hospital, Urbino, Italy.

出版信息

J Cardiovasc Med (Hagerstown). 2008 Jan;9(1):39-42. doi: 10.2459/JCM.0b013e328011e6b3.

DOI:10.2459/JCM.0b013e328011e6b3

PMID:18268417

Abstract

OBJECTIVE

The aim of this pilot study was to estimate the survival trend of patients implanted with VDD pacemakers, and to compare it with the survival curve of the general population of the same region.

METHODS

Ninety-seven patients (65 male, mean age 78 +/- 6 years) with advanced atrioventricular block referred to our institution were implanted with single-lead VDD pacemakers. All patients were stimulated at the right ventricular apex. At each follow-up visit, a clinical examination was performed and telemetric data collected. In case of death, the family was contacted to record the cause of death. Data on the survival probability of the general population in the Marche Region were obtained from the Italian Institute of Statistics (ISTAT).

RESULTS

During the follow-up (mean 7 +/- 6 years), 17 patients (17.5%) died and eight patients (8.2%) developed atrial fibrillation. Atrioventricular synchrony was 97 +/- 3% in the overall patient population, excluding patients with atrial fibrillation. Only one patient was upgraded to DDD pacing owing to symptomatic loss of atrial sensing; after the upgrading procedure symptoms disappeared. During the follow-up period, 19 pacemakers were replaced for end of life of the battery. Patients who died during follow-up were aged 80 +/- 7 years at implantation and 85 +/- 6 years at death. The comparison between the trend line simulating the patient survival probability of the studied VDD population, and the survival probability of males in the Marche Region did not show any significant difference.

CONCLUSIONS

In patients chronically paced with a single-lead VDD system, survival probability seems to be similar to that of the general population.

摘要

目的

本初步研究的目的是评估植入VDD起搏器患者的生存趋势，并将其与同一地区普通人群的生存曲线进行比较。

方法

97例（65例男性，平均年龄78±6岁）患有晚期房室传导阻滞并转诊至我院的患者植入了单腔VDD起搏器。所有患者均在右心室心尖部进行起搏。每次随访时，进行临床检查并收集遥测数据。如患者死亡，与家属联系记录死因。马尔凯地区普通人群的生存概率数据来自意大利国家统计局（ISTAT）。

结果

在随访期间（平均7±6年），17例患者（17.5%）死亡，8例患者（8.2%）发生心房颤动。排除心房颤动患者后，总体患者人群的房室同步率为97±3%。仅1例患者因心房感知功能有症状性丧失而升级为DDD起搏；升级手术后症状消失。随访期间，19台起搏器因电池寿命结束而更换。随访期间死亡的患者植入时年龄为80±7岁，死亡时年龄为85±6岁。模拟研究的VDD人群患者生存概率的趋势线与马尔凯地区男性生存概率之间的比较未显示任何显著差异。