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Reveal LINQ与Reveal XT植入式循环记录仪:术中及术后比较

Reveal LINQ Versus Reveal XT Implantable Loop Recorders: Intra- and Post-Procedural Comparison.

作者信息

Nguyen Hoang H, Law Ian H, Rudokas Michael W, Lampe Jennifer, Bowman Tammy M, Van Hare George F, Avari Silva Jennifer N

机构信息

Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO.

Division of Cardiology, Department of Pediatrics, University of Iowa Carver School of Medicine, Iowa City, IA.

出版信息

J Pediatr. 2017 Aug;187:290-294. doi: 10.1016/j.jpeds.2017.04.057. Epub 2017 May 22.

Abstract

OBJECTIVES

To compare the procedure, recovery, hospitalization times, and costs along with patient/parent satisfaction after newer-generation cardiac implantable loop recorder (Reveal LINQ; Medtronic Inc, Minneapolis, Minnesota) and previous-generation implantable loop recorder (Reveal XT; Medtronic Inc).

STUDY DESIGN

A prospective study of patients undergoing LINQ implantations between April 2014 and October 2015 was performed. Retrospective chart review of patients undergoing XT implantations was performed for comparison.

RESULTS

Thirty-one patients received LINQ and 15 patients received XT. Indications included syncope/palpitations (28/46, 61%), history of arrhythmias (9/46, 20%), arrhythmia burden in congenital heart disease (5/46, 10%), and monitoring in channelopathies (4/46, 9%). The LINQ group underwent more conscious sedation procedures than the XT group (8/31 vs 0/15, P = .04) with shorter procedural time (9 vs 34 minutes, P <.001), room occupation time (38 vs 81 minutes, P <.001), recovery time (21 vs 67 minutes, P <.001), and total hospital time (214 vs 264 minutes, P = .046). The LINQ group also had shorter return to activity time (2 vs 5 days, P = 1). Three device erosions in the LINQ group required reintervention. The LINQ group had fewer body image issues than the XT group (1/26 vs 5/14, P = .01) with both groups scoring 5/5 overall patient/parent satisfaction score at follow-up. Both groups had comparable total direct hospital costs (US $5905 vs $5438, P = .8).

CONCLUSIONS

LINQ offers better procedural and recovery time compared with XT. LINQ implantations under conscious sedation reduce total hospitalization time.

摘要

目的

比较新一代心脏植入式循环记录仪(Reveal LINQ;美敦力公司,明尼阿波利斯,明尼苏达州)与上一代植入式循环记录仪(Reveal XT;美敦力公司)在手术过程、恢复情况、住院时间、费用以及患者/家长满意度方面的差异。

研究设计

对2014年4月至2015年10月期间接受LINQ植入的患者进行前瞻性研究。对接受XT植入的患者进行回顾性病历审查以作比较。

结果

31例患者接受了LINQ,15例患者接受了XT。适应证包括晕厥/心悸(28/46,61%)、心律失常病史(9/46,20%)、先天性心脏病中的心律失常负荷(5/46,10%)以及通道病监测(4/46,9%)。LINQ组比XT组接受更多的清醒镇静手术(8/31 vs 0/15,P = 0.04),手术时间更短(9 vs 34分钟,P < 0.001)、占用房间时间更短(38 vs 81分钟,P < 0.001)、恢复时间更短(21 vs 67分钟,P < 0.001)以及总住院时间更短(214 vs 264分钟,P = 0.046)。LINQ组恢复活动的时间也更短(2 vs 5天,P = 1)。LINQ组有3例设备侵蚀需要再次干预。LINQ组比XT组的身体形象问题更少(1/26 vs 5/14,P = 0.01),两组在随访时患者/家长总体满意度评分均为5/5。两组的直接住院总费用相当(5905美元 vs 5438美元,P = 0.8)。

结论

与XT相比,LINQ的手术过程和恢复时间更佳。清醒镇静下的LINQ植入可缩短总住院时间。

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