Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Cardiovascular Department, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
Europace. 2015 Jan;17(1):69-77. doi: 10.1093/europace/euu233. Epub 2014 Oct 21.
The National Swedish Pacemaker and Implantable Cardioverter-Defibrillator (ICD) Registry collects prospective data on all pacemaker and ICD implants in Sweden. We aimed to report the 2012 findings of the Registry concerning electrical devices implantation rates and changes over time, 1 year complications, long-term device longevity and patient survival.
Forty-four Swedish implanting centres continuously contribute implantation of pacemakers and ICDs to the Registry by direct data entry on a specific website. Clinical and technical information on 2012 first implants and postoperative complications were analysed and compared with previous years. Patient survival data were obtained from the Swedish population register database. In 2012, the mean pacemaker and ICD first implantation rates were 697 and 136 per million inhabitants, respectively. The number of cardiac resynchronization therapy (CRT) first implantations/million capita was 41 (CRT pacemakers) and 55 (CRT defibrillators), with only a slight increase in CRT-ICD rate compared with 2011. Most device implantations were performed in men. Complication rates for pacemaker and ICD procedures were 5.3 and 10.1% at 1 year, respectively. Device and lead longevity differed among manufacturers. Pacemaker patients were older at the time of first implant and had generally worse survival rate than ICD patients (63 vs. 82% after 5 years).
Pacemaker and ICD implantation rates seem to have reached a level phase in Sweden. Implantable cardioverter-defibrillator and CRT implantation rates are very low and do not reflect guideline indications. Gender differences in CRT and ICD implantations are pronounced. Device and patient survival rates are variable, and should be considered when deciding device type.
国家瑞典起搏器和植入式心脏复律除颤器(ICD)注册中心收集了所有起搏器和 ICD 植入的前瞻性数据。我们旨在报告 2012 年该注册中心关于电设备植入率及其随时间的变化、1 年并发症、长期设备寿命和患者生存率的结果。
44 家瑞典植入中心通过特定网站上的直接数据输入,持续向该注册中心贡献起搏器和 ICD 的植入数据。对 2012 年首次植入的临床和技术信息进行了分析,并与前几年进行了比较。患者生存数据来自瑞典人口登记数据库。2012 年,平均起搏器和 ICD 首次植入率分别为 697 和 136/百万居民。每百万居民的心脏再同步治疗(CRT)首次植入数量为 41(CRT 起搏器)和 55(CRT 除颤器),与 2011 年相比,CRT-ICD 比率略有增加。大多数设备植入都是在男性中进行的。起搏器和 ICD 手术的并发症发生率分别为 1 年后的 5.3%和 10.1%。不同制造商的设备和导线寿命存在差异。首次植入时,起搏器患者年龄较大,总体生存率低于 ICD 患者(5 年后分别为 63%和 82%)。
起搏器和 ICD 植入率似乎已在瑞典达到稳定阶段。植入式心脏复律除颤器和 CRT 植入率非常低,并不反映指南的适应证。CRT 和 ICD 植入的性别差异显著。设备和患者的生存率存在差异,在决定设备类型时应予以考虑。