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生物电阻抗人体成分分析对植入式心脏装置功能的影响。

Effect of bioimpedance body composition analysis on function of implanted cardiac devices.

作者信息

Buch Eric, Bradfield Jason, Larson Tianne, Horwich Tamara

机构信息

UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.

出版信息

Pacing Clin Electrophysiol. 2012 Jun;35(6):681-4. doi: 10.1111/j.1540-8159.2012.03377.x. Epub 2012 Mar 27.

Abstract

BACKGROUND

It is routinely recommended that patients with pacemakers, implantable cardioverter defibrillators (ICD), and cardiac resynchronization therapy-defibrillators (CRT-D) avoid bioelectrical impedance analysis (BIA)--a commonly used method to estimate body composition--because of the concern for the potential for BIA interference with pacemaker or ICD function. However, the prevalence of such interference is not known.

OBJECTIVE

Assess for incidence of interference between BIA and ICD or CRT-D devices.

METHODS AND RESULTS

Twenty patients with heart failure and cardiac implanted electronic devices (50% ICD, 50% CRT-D) underwent BIA during real-time device interrogation to detect interference. Study patients were 90% male, with mean age 54 ± 14 years, and mean LVEF 23 ± 11%. Devices from all four leading cardiac device manufacturers were included. Device therapies were temporarily disabled to prevent inappropriate shocks. During body composition testing using BIA, no evidence of interference with ICD function was seen in any patient, including no telemetry disruption, no oversensing on any lead, and no patient symptoms.

CONCLUSIONS

Despite the manufacturers' recommendation to avoid BIA in patients with ICDs, this study showed no evidence of any interference in 20 patients. Bioimpedance analysis might be safe in such patients, but further confirmatory studies are required.

摘要

背景

通常建议植入起搏器、植入式心脏复律除颤器(ICD)和心脏再同步治疗除颤器(CRT-D)的患者避免使用生物电阻抗分析(BIA)——一种常用的估计身体成分的方法,因为担心BIA可能干扰起搏器或ICD的功能。然而,这种干扰的发生率尚不清楚。

目的

评估BIA与ICD或CRT-D设备之间干扰的发生率。

方法与结果

20例植入心脏电子设备的心力衰竭患者(50%为ICD,50%为CRT-D)在实时设备问询期间接受BIA检查以检测干扰。研究患者90%为男性,平均年龄54±14岁,平均左心室射血分数23±11%。纳入了所有四家主要心脏设备制造商的设备。暂时停用设备治疗以防止不适当的电击。在使用BIA进行身体成分测试期间,未在任何患者中发现干扰ICD功能的证据,包括无遥测中断、任何导联无过感知以及无患者症状。

结论

尽管制造商建议ICD患者避免使用BIA,但本研究显示20例患者中无任何干扰证据。生物电阻抗分析在此类患者中可能是安全的,但需要进一步的验证性研究。

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