Lau Ernest W
Department of Cardiology, Royal Victoria Hospital, Belfast, Northern Ireland.
Pacing Clin Electrophysiol. 2019 Apr;42(4):407-422. doi: 10.1111/pace.13642. Epub 2019 Mar 5.
The longevity of a cardiac implantable electronic device (CIED) depends on how quickly the powers consumed by the device's functions exhaust its usable battery energy. A mathematical model for CIED power consumptions was developed and validated against longevity data from manufacturers.
The programmable parameters for the Resonate X4 cardiac resynchronization therapy defibrillators (CRT-Ds) on the Boston Scientific (St. Paul, MN, USA) online longevity calculator were designated as independent terms in the sum for the total power consumption. The reciprocal of longevity was plotted against variations in these terms. Linear and nonlinear regression analyses were used to fit the plots. The power consumed by pacing was theoretically derived and used as the calibrating tool for estimating the powers consumed by other functions and the usable battery energy. The same methodology was applied to the longevity data of other manufacturers' CRT-Ds.
Single chamber 100% pacing at 60 beats/min, 2.5 V, 0.4 ms, 500 Ω consumes ≈ 144 J/year. Shock therapy is 45-85% energy efficient. Multichamber pacing modes and maintaining readiness to pace a chamber consume power even if no pacing is delivered. Switching voltage regulation is theoretically more energy efficient than linear voltage regulation for powering pacing.
The powers consumed by therapy functions are dictated by the patient's clinical needs, but healthcare professionals can extend device longevity by switching off dormant functions and simplifying the pacing mode. Choosing a device model with large usable battery energy, low background power, and energy efficient pacing and shock therapy for implantation will increase the probability of a long service lifespan.
心脏植入式电子设备（CIED）的使用寿命取决于该设备各项功能所消耗的电量耗尽其可用电池能量的速度。我们开发了一种CIED功耗的数学模型，并根据制造商提供的寿命数据进行了验证。
将美国明尼苏达州圣保罗市波士顿科学公司在线寿命计算器上Resonate X4心脏再同步治疗除颤器（CRT-D）的可编程参数指定为总功耗总和中的独立项。将寿命的倒数与这些项的变化进行绘图。使用线性和非线性回归分析来拟合这些图。从理论上推导了起搏所消耗的功率，并将其用作估计其他功能所消耗的功率和可用电池能量的校准工具。同样的方法应用于其他制造商CRT-D的寿命数据。
单腔以60次/分钟、2.5伏、0.4毫秒、500欧姆的频率进行100%起搏时，每年消耗约144焦耳。电击治疗的能量效率为45%-85%。即使没有进行起搏，多腔起搏模式以及保持对某一腔室起搏的准备状态也会消耗功率。从理论上讲，开关电压调节在为起搏供电方面比线性电压调节更节能。
治疗功能所消耗的功率由患者的临床需求决定，但医疗保健专业人员可以通过关闭休眠功能和简化起搏模式来延长设备的使用寿命。选择具有大可用电池能量、低背景功率以及节能起搏和电击治疗功能的设备型号进行植入，将增加长使用寿命的可能性。
