Zeljkovic Ivan, Burri Haran, Breitenstein Alexander, Ammann Peter, Mueller Andreas, Auricchio Angelo, Delacrétaz Etienne, Dickstein Kenneth, Linde Cecilia, Normand Camilla, Sticherling Christian
University Hospital Basel, Switzerland.
University Hospital Geneva, Switzerland.
Swiss Med Wkly. 2018 Aug 22;148:w14643. doi: 10.4414/smw.2018.14643. eCollection 2018 Aug 13.
Between October 2015 and December 2016, 11,088 patients from 42 countries having cardiac resynchronisation therapy (CRT) devices implanted were included in the CRT II Survey. We compared the characteristics of Swiss CRT recipients with the overall European population.
Demographic and procedural data from seven Swiss centres recruiting all consecutive patients undergoing either de-novo CRT implantation or an upgrade to a CRT system were collected and compared with the European population.
A total of 320 Swiss patients (24.4% female, mean age 71.0 ± 10.2 years, 47% ischaemic cardiomyopathy) were enrolled, which amounts to 38% of all CRT implantations in Switzerland during this period. Of the patients enrolled, 38% had atrial fibrillation, 27% second- or third-degree atrioventricular block, and 68% complete left bundle-branch block. Swiss patients had significantly less often the classical indication of heart failure with a wide QRS complex (40 vs 61%; odds ratio [OR] 0.44, 95% confidence interval [CI] 0.35-0.55; p <0.001). Compared with the European population, Swiss patients were significantly older (71 vs 68.5 years, p <0.001), less symptomatic from heart failure and had more chronic kidney disease. Swiss patients significantly more often received a CRT-pacemaker (37 vs 30%; OR 1.37; 95% CI 1.09-1.73; p = 0.007) and quadripolar left ventricular leads (69 vs 57%; OR 1.67, 95% CI 1.32-2.13; p <0.001).
Compared with European CRT recipients, Swiss CRT patients are older, less symptomatic and suffer more often from comorbidities. Although two thirds of the implantations were CRT-defibrillator systems, Swiss patients more often received CRT-pacemaker systems than their European counterparts.
在2015年10月至2016年12月期间，来自42个国家的11088例植入心脏再同步治疗（CRT）设备的患者被纳入CRT II调查。我们比较了瑞士CRT接受者与整个欧洲人群的特征。
收集了瑞士7个中心招募的所有连续接受初次CRT植入或升级为CRT系统患者的人口统计学和手术数据，并与欧洲人群进行比较。
共纳入320例瑞士患者（女性占24.4%，平均年龄71.0±10.2岁，47%为缺血性心肌病），占该时期瑞士所有CRT植入手术的38%。在纳入的患者中，38%患有房颤，27%患有二度或三度房室传导阻滞，68%患有完全性左束支传导阻滞。瑞士患者出现伴有宽QRS波群的经典心力衰竭指征的情况明显较少（40%对61%；优势比[OR]0.44，95%置信区间[CI]0.35 - 0.55；p<0.001）。与欧洲人群相比，瑞士患者年龄明显更大（71岁对68.5岁，p<0.001），心力衰竭症状较轻，慢性肾病更多。瑞士患者接受CRT起搏器的比例明显更高（37%对30%；OR 1.37；95%CI 1.09 - 1.73；p = 0.007），接受四极左心室导线的比例也更高（69%对57%；OR 1.67，95%CI 1.32 - 2.13；p<0.001）。
与欧洲CRT接受者相比，瑞士CRT患者年龄更大，症状较轻，合并症更多。尽管三分之二的植入手术是CRT除颤器系统，但瑞士患者接受CRT起搏器系统的频率高于欧洲同行。
