设备更新成功减少了皮下植入式心律转复除颤器（ICD）患者的T波过度感知和不适当电击。
Device updates successfully reduce T‑wave oversensing and inappropriate shocks in subcutaneous ICD patients.
作者信息
Larbig R, Motloch L J, Bettin M, Fischer A, Bode N, Frommeyer G, Loeher A, Koebe J, Reinke F, Eckardt L
机构信息
Division of Electrophysiology, Department of Cardiovascular Medicine, University of Muenster, Muenster, Germany.
Department of Internal Medicine II, Paracelsus Medical University, Salzburg, Austria.
出版信息
Neth Heart J. 2018 Dec;26(12):606-611. doi: 10.1007/s12471-018-1160-y.
AIMS
To analyse the impact of device and software updates on the prevention of T‑wave oversensing (TWOS) and inappropriate shocks (IS) in subcutaneous ICD (S-ICD) patients.
BACKGROUND
TWOS is a feared complication after implantation. It may lead to harmful IS. To date, specific strategies to reduce these events are lacking.
METHODS
In this retrospective single-centre trial we analysed 146 S‑ICD patients who were implanted between 2010 and 2016. In all eligible consecutive patients (n = 139), follow-up of at least 6 weeks was studied. The incidence of TWOS/IS was analysed in patients receiving a 2 generation S‑ICD (Emblem-S-ICD) between 2014 and 2016 (Emblem). Their outcome was compared with a control group (SQ) treated with the SQ1010 device between 2010 and 2014, who were followed up for a maximum of 2 years. Furthermore, to test if the software update SMR8 reduces inappropriate shocks in the SQ1010-S-ICD population, the incidence of TWOS/IS was evaluated before and after update installation.
RESULTS
Basic characteristics and indications for S‑ICD implantation were similar in both groups. However, the cumulative incidence of TWOS/IS was significantly decreased in Emblem vs. SQ (SQ: 15.4%, n = 14/91 vs. Emblem 4.2%, n = 2/48; p = 0.049). Furthermore, with regards to the SQ population we also observed a trend towards a significant reduction of TWOS/IS after installation of the software update SMR8 in 2014 (before update: 13.4%, n = 11/82 vs. after update: 4.6%, 3/65, p = 0.07).
CONCLUSION
2 generation devices but probably also the SMR8 software update reduce the incidence of TWOS/IS in S‑ICD patients.
目的
分析设备和软件更新对皮下植入式心律转复除颤器（S-ICD）患者T波过度感知（TWOS）及不适当电击（IS）预防的影响。
背景
TWOS是植入术后令人担忧的并发症，可能导致有害的IS。迄今为止，缺乏减少这些事件的具体策略。
方法
在这项回顾性单中心试验中，我们分析了2010年至2016年间植入S-ICD的146例患者。在所有符合条件的连续患者（n = 139）中，研究了至少6周的随访情况。分析了2014年至2016年间接受第二代S-ICD（Emblem-S-ICD，简称Emblem）患者的TWOS/IS发生率，并将其结果与2010年至2014年间接受SQ1010设备治疗的对照组（SQ）进行比较，SQ组随访时间最长为2年。此外，为了测试软件更新SMR8是否能减少SQ1010-S-ICD人群中的不适当电击，在安装更新前后评估了TWOS/IS的发生率。
结果
两组患者S-ICD植入的基本特征和适应症相似。然而，Emblem组TWOS/IS的累积发生率显著低于SQ组（SQ组：15.4%，n = 14/91；Emblem组：4.2%，n = 2/48；p = 0.049）。此外，对于SQ人群，我们还观察到在2014年安装软件更新SMR8后，TWOS/IS有显著降低的趋势（更新前：13.4%，n = 11/82；更新后：4.6%，3/65，p = 0.07）。
结论
第二代设备以及SMR8软件更新可能会降低S-ICD患者TWOS/IS的发生率。
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