Caisse nationale d'assurance maladie des travailleurs salariés, Paris, France.
Arch Cardiovasc Dis. 2011 May;104(5):332-42. doi: 10.1016/j.acvd.2011.04.002. Epub 2011 Jun 1.
An ageing population and the extension of indications will in all probability result in an increasing number of cardiac device implantations.
Patients implanted in 2008 and 2009 were identified by means of the French National Hospital Discharge database to establish the implantation rate and the National Health Insurance (NHI) Information System database for patient profiles (76% of the population).
Of the 64,306 pacemaker implantations (1003.7 per million inhabitants [pmi]) in 2009, 21.4% were single chamber, 75.4% double chamber and 3.2% triple chamber (CRT-P). Of the 9028 cardioverter-defibrillator implantations (140.8 pmi) in 2009, 30.1% were single chamber, 27.5% double chamber and 42.5% triple chamber (CRT-D), accounting for 65% of cardiac resynchronization therapy (CRT) implants. Among NHI beneficiaries, 58.6% of cardioverter-defibrillators were implanted for primary prevention. Between 2008 and 2009, CRT-P implantations increased by 8.8% and CRT-D implantations by 29.3%. Regional variations in implantation rates were observed regarding single-chamber pacemakers (15-33%) and CRT-D among CRT (46.2-73.8%). Pacemaker implantations cost €158.4 million overall, 4.5% of which was for CRT-P; cardioverter-defibrillator implantations cost €96 million, 49% of which was for CRT-D. For NHI beneficiaries, 11.9% of CRT-P patients and 6.5% of CRT-D patients already had a device of the same type implanted in the 3 preceding years.
The results confirm the increase in cardioverter-defibrillator implantations in France. The implantation rate remains lower than that in the USA but falls within the European average. Reasons behind significant regional variations in implantation rates need further study.
人口老龄化和适应证的扩大极有可能导致心脏装置植入数量的增加。
通过法国国家住院数据库确定 2008 年和 2009 年植入的患者，以建立植入率，并通过国家健康保险（NHI）信息系统数据库确定患者资料（占人口的 76%）。
2009 年共植入 64306 个起搏器（每百万居民 1003.7 个），其中单腔 21.4%，双腔 75.4%，三腔（CRT-P）3.2%。2009 年共植入 9028 个除颤器（每百万居民 140.8 个），其中单腔 30.1%，双腔 27.5%，三腔（CRT-D）42.5%，占心脏再同步治疗（CRT）植入的 65%。在 NHI 受惠者中，58.6%的除颤器植入用于一级预防。2008 年至 2009 年期间，CRT-P 植入增加了 8.8%，CRT-D 植入增加了 29.3%。在单腔起搏器（15-33%）和 CRT（46.2-73.8%）中观察到 CRT-D 之间存在植入率的区域差异。起搏器总费用为 1.584 亿欧元，其中 4.5%为 CRT-P；除颤器总费用为 9600 万欧元，其中 49%为 CRT-D。对于 NHI 受惠者，11.9%的 CRT-P 患者和 6.5%的 CRT-D 患者在过去 3 年中已经植入了相同类型的设备。
结果证实法国除颤器植入数量的增加。植入率仍低于美国，但属于欧洲平均水平。植入率存在显著的区域差异的原因需要进一步研究。
