InParys Clinical Research Associates, St Cloud 92210, France.
Europace. 2011 Nov;13(11):1568-73. doi: 10.1093/europace/eur238. Epub 2011 Jul 22.
The rates of cardiac defibrillator implantation (ICD) in Europe and within countries are heterogeneous. We examined the characteristics of ICD recipients and device implantation rates in France, with the goal of identifying patterns and regional differences in medical practices.
We compiled the information available on devices and patients from a manufacturer's database for the years 2008 and 2009 and the Stidefix national registry from January 2008 to April 2010 and reported the descriptive statistics and comparisons of implantation practices among regions. We analysed data from 10 766 patients enrolled in Stidefix (mean age=63 ± 13 years; 83% men) after implantation of single-chamber (24%), dual-chamber (33%), or triple-chamber (43%) ICD. Implantation was for primary prevention in 63% of patients. Between 2008 and 2009, the national implant rate increased from 126 to 147 per million inhabitants, with regional variations related to the number of cardiologists and of implant centres. Patients were significantly older and more likely to undergo implantation for primary prevention or for cardiac resynchronization therapy (CRT) in higher-volume regions. In Ile de France (Paris and its suburbs), patients tended to be younger, as in low-implantation regions, but with a high rate of CRT implants, as in high-implantation regions. A comparison of the Stidefix data with the manufacturer's database revealed that only 57% of all ICD implanted in 2009 were reported to Stidefix.
Despite an increasing rate of ICD implantation in France, important regional disparities persist, with a median position occupied by Ile de France.
欧洲各国及各国之间的心脏除颤器（ICD）植入率存在差异。本研究旨在分析法国 ICD 患者的特征和器械植入率，以明确法国各地的医疗实践模式和差异。
我们从制造商数据库中整理了 2008 年和 2009 年器械和患者的信息，并结合 Stidefix 国家注册中心（2008 年 1 月至 2010 年 4 月）的数据，报告了器械植入率的描述性统计数据和地区间差异。共纳入 Stidefix 中心植入单腔（24%）、双腔（33%）或三腔（43%）ICD 的 10766 例患者。术后平均年龄为 63±13 岁（83%为男性）。63%的患者接受 ICD 植入是出于一级预防。2008 年至 2009 年，全国植入率从 126/百万人增至 147/百万人，地区差异与心脏病专家和植入中心数量有关。高容量地区的患者年龄较大，更倾向于接受一级预防或心脏再同步治疗（CRT）的植入。法兰西岛（巴黎及其郊区）患者年龄相对较小，类似于低植入地区，但 CRT 植入率较高，类似于高植入地区。与制造商数据库相比，Stidefix 中心的数据仅覆盖了 2009 年植入的 ICD 的 57%。
尽管法国 ICD 植入率不断上升，但仍存在显著的地区差异，法兰西岛地区处于中等水平。
