Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia.
Intern Med J. 2013 Aug;43(8):888-95. doi: 10.1111/imj.12201.
Implantable cardioverter defibrillators (ICD) have been demonstrated to reduce mortality in survivors of life-threatening arrhythmias (secondary prevention) and in patients at increased risk of sudden cardiac death (primary prevention). Other nations have reported significant increases in ICD use in recent years.
To investigate Australian nationwide trends of ICD procedures over a 10-year period (2000-2009).
A retrospective analysis of the Australian Institute of Health and Welfare's National Hospital Morbidity Database was performed to determine the annual number of ICD implantation and replacement procedures between 2000 and 2009. Rates were calculated using Australian Bureau of Statistics data on the annual estimated population. Time trends in the yearly procedure number and rate were analysed using negative binomial regression models with comparisons made by age and sex.
The number of new ICD implantations increased from 708 to 3198 procedures between 2000 and 2009. Replacement procedures increased from 290 to 1378. The implantation rate (per million) increased from 37.0 to 145.6 and the replacement rate from 15.1 to 62.7. When rates were adjusted for age and sex, the implantation rate increased annually by 15.8% and the replacement rate by 16.6% (P < 0.0001). Procedures occurred most commonly in men (implantations: 80.1%; replacements: 78.0%) between ages 70-79.
ICD procedures increased significantly in Australia between 2000-2009. Despite these increases, other studies have suggested ICD devices are currently under-utilised. During the study period, males accounted for the majority of ICD procedures. While there are numerous reasons for this, it is not known if device under-use is more common in females.
植入式心脏复律除颤器（ICD）已被证明可降低威胁生命的心律失常（二级预防）幸存者和发生心脏性猝死风险增加的患者（一级预防）的死亡率。其他国家报告近年来 ICD 使用显著增加。
调查澳大利亚在 10 年内（2000-2009 年）ICD 手术的全国趋势。
对澳大利亚卫生福利研究所国家医院发病率数据库进行回顾性分析，以确定 2000 年至 2009 年间 ICD 植入和更换手术的年例数。使用澳大利亚统计局关于年度估计人口的数据计算比率。使用负二项回归模型分析每年手术数量和比率的时间趋势，并按年龄和性别进行比较。
2000 年至 2009 年，新植入 ICD 的数量从 708 例增加到 3198 例。更换手术从 290 例增加到 1378 例。植入率（每百万）从 37.0 增加到 145.6，更换率从 15.1 增加到 62.7。当根据年龄和性别调整比率时，植入率每年增加 15.8%，更换率增加 16.6%（P<0.0001）。手术最常见于 70-79 岁的男性（植入：80.1%；更换：78.0%）。
2000-2009 年，澳大利亚 ICD 手术显著增加。尽管有所增加，但其他研究表明 ICD 设备目前未得到充分利用。在研究期间，男性占 ICD 手术的大部分。虽然有很多原因，但尚不清楚女性是否更常见设备未使用。
