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起搏器植入后的生存率:一项针对病态窦房结综合征和房室传导阻滞患者起搏治疗的研究。

Survival rates after pacemaker implantation: a study of patients paced for sick sinus syndrome and atrioventricular block.

作者信息

Zanini R, Facchinetti A, Gallo G, Benedini G, Metra M, Assanelli D, Cicogna R

机构信息

Department of Cardiology, Spedali Civili, Brescia, Italy.

出版信息

Pacing Clin Electrophysiol. 1989 Jul;12(7 Pt 1):1065-9. doi: 10.1111/j.1540-8159.1989.tb01927.x.

Abstract

It is still a matter of controversy as to whether the patients paced for atrioventricular block (AVB) have different prognosis and survival rates than those paced for Sick Sinus Syndrome (SSS). We have compared the survival rates of 962 AVB patients (group A) with that of 283 SSS patients (group B) who underwent pacemaker implantation during the period January 1968 to December 1986. The survival rate graphs of the examined groups were calculated using the actuarial method and the differences in the survival rates between the groups were evaluated using the Logrank test. Our results show that SSS patients have a higher survival rate than AV block with a difference on the rate of survival between the two groups reaching the borderline of statistical significance. Multivariate discriminant analysis was then used to assess that of the parameters (i.e., age at the time of implantation, sex, electrophysiological indication to pacing, etiology or pacing mode) could have had the main influence upon mortality and the different pattern of the survival rate graph within the two groups of patients. Our data show that survival is mostly related to age, pacing mode and, although more slightly, to underlying heart disease; the electrophysiological indication to pacing, instead, does not significantly influence it.

摘要

对于因房室传导阻滞(AVB)而接受起搏治疗的患者与因病态窦房结综合征(SSS)而接受起搏治疗的患者相比,其预后和生存率是否不同,仍然存在争议。我们比较了1968年1月至1986年12月期间接受起搏器植入的962例AVB患者(A组)和283例SSS患者(B组)的生存率。使用精算方法计算受检组的生存率图,并使用对数秩检验评估两组之间生存率的差异。我们的结果表明,SSS患者的生存率高于AV阻滞患者,两组之间的生存率差异达到统计学意义的临界值。然后使用多变量判别分析来评估哪些参数(即植入时的年龄、性别、起搏的电生理指征、病因或起搏模式)可能对死亡率以及两组患者生存率图的不同模式产生主要影响。我们的数据表明,生存率主要与年龄、起搏模式有关,并且虽然与潜在心脏病的关系较小;相反,起搏的电生理指征对其没有显著影响。

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