Centre of Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
Chin Med J (Engl). 2012 Oct;125(19):3421-4.
The impact of home monitoring system in the early detection of ventricular arrhythmia and inappropriate shock in daily work is not clear. The aim of this study was to investigate the impact of home monitoring system on the early detection of ventricular arrhythmia and inappropriate shock in daily clinical practice.
Cases of implantable cardioverter defibrillator (ICD) implantation with or without the home monitoring system from June 2010 to October 2011 at our center were reviewed. Follow-up was scheduled after implantation. Data relating to the home monitoring ICD were retrieved using a remote transmitter system. Data relating to the other devices were obtained during scheduled follow-up or unscheduled visits.
Our study involved 69 patients (mean age (68.4 ± 17.6) years, 64.3% males, 26 in the home monitoring group vs. 43 in the non-home monitoring group). In all, 561 ventricular arrhythmia episodes were detected in 17 patients (39.5%) in the non-home monitoring group: 495 episodes were ventricular tachycardia and 66 episodes were ventricular fibrillation; among these, 476 episodes of ventricular tachycardia and 45 episodes of ventricular fibrillation were appropriately diagnosed (96.1% and 68.2%, respectively). In the home monitoring group, 389 ventricular arrhythmia episodes were transmitted by the home monitoring system in nine patients (34.6%): 348 ventricular tachycardia episodes and 41 ventricular fibrillation episodes. Device detection was appropriate in 348 ventricular tachycardia episodes (100.0%) and 36 ventricular fibrillation episodes (87.8%). The home monitoring group showed a higher appropriate detection rate of ventricular tachycardia (P < 0.01) and ventricular fibrillation (P = 0.02). The proportion of inappropriate shock was comparable in the two groups (6/11 in the non-home monitoring group vs. 1/7 in the home monitoring group; P = 0.08).
The home monitoring ICD was able to provide information relating to inappropriate detection and shock earlier than conventional devices. It proved to be a reliable tool and has a strong potential to provide greater reaction time in the case of inappropriate shock.
家庭监测系统在日常工作中对室性心律失常和不适当电击的早期检测的影响尚不清楚。本研究旨在探讨家庭监测系统对日常临床实践中心律失常和不适当电击的早期检测的影响。
回顾了 2010 年 6 月至 2011 年 10 月在我院植入植入式心律转复除颤器（ICD）的患者的病例，无论是否植入家庭监测系统。植入后进行随访。使用远程发射器系统检索与家庭监测 ICD 相关的数据。与其他设备相关的数据是在预定随访或非预定就诊期间获得的。
本研究共纳入 69 例患者（平均年龄（68.4 ± 17.6）岁，男性 64.3%，家庭监测组 26 例，非家庭监测组 43 例）。非家庭监测组共 17 例患者检测到 561 次室性心律失常发作（39.5%）：561 次为室性心动过速，66 次为室颤；其中，476 次室性心动过速和 45 次室颤被正确诊断（96.1%和 68.2%）。家庭监测组 9 例患者通过家庭监测系统传输 389 次室性心律失常（34.6%）：348 次室性心动过速和 41 次室颤。348 次室性心动过速（100.0%）和 36 次室颤（87.8%）被设备正确检测。家庭监测组室性心动过速（P<0.01）和室颤（P=0.02）的正确检测率更高。两组的不适当电击比例相当（非家庭监测组 6/11 例，家庭监测组 1/7 例；P=0.08）。
家庭监测 ICD 能够提供比传统设备更早的关于不适当检测和电击的信息。它是一种可靠的工具，在不适当电击的情况下有更强的反应时间潜力。
