真实世界中可穿戴式心脏复律除颤器的应用经验——欧洲单中心缺血性心肌病患者的极高恰当电击率
A real world wearable cardioverter defibrillator experience - Very high appropriate shock rate in ischemic cardiomyopathy patients at a European single-center.
作者信息
Beiert Thomas, Malotki Robert, Kraemer Natalie, Stöckigt Florian, Linhart Markus, Nickenig Georg, Schrickel Jan W, Andrié René P
机构信息
Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
Department of Internal Medicine II, University Hospital Bonn, Rheinische Friedrich-Wilhelms University, Bonn, Germany.
出版信息
J Electrocardiol. 2017 Sep-Oct;50(5):603-609. doi: 10.1016/j.jelectrocard.2017.04.017. Epub 2017 Apr 28.
BACKGROUND
The wearable cardioverter defibrillator (WCD) has emerged as a valuable tool to protect patients with increased risk of sudden cardiac death (SCD). We sought to characterize WCD patients and to analyze predictors of ventricular arrhythmia (VA) occurrence and WCD shock delivery.
METHODS AND RESULTS
One hundred fourteen patients with WCD use were included in the study. Indications were mainly ischemic cardiomyopathy (ICM; 31.6%), non-ICM (45.6%) and explantation of implantable cardioverter defibrillator due to device infection (11.4%). We observed sustained VA in 9.6% of the study population and 6.1% received an appropriate shock. VA occurred in 16.7% of ICM, 3.8% of non-ICM and 15.4% of patients with device infection.
CONCLUSIONS
Our data demonstrate a very high rate of sustained VA in patients at risk for SCD during WCD use. ICM patients, including those with recent MI, bore the highest risk.
背景
可穿戴式心脏复律除颤器（WCD）已成为保护心脏性猝死（SCD）风险增加患者的一项重要工具。我们旨在对使用WCD的患者进行特征描述，并分析室性心律失常（VA）发生及WCD电击治疗的预测因素。
方法与结果
本研究纳入了114例使用WCD的患者。适应证主要为缺血性心肌病（ICM；31.6%）、非ICM（45.6%）以及因设备感染而取出植入式心脏复律除颤器（11.4%）。我们在9.6%的研究人群中观察到持续性VA，6.1%的患者接受了恰当电击。VA发生于16.7%的ICM患者、3.8%的非ICM患者以及15.4%的设备感染患者中。
结论
我们的数据表明，在使用WCD期间，SCD风险患者中持续性VA的发生率非常高。ICM患者，包括近期发生心肌梗死的患者，风险最高。
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