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澳大利亚 10 年对比研究:导管消融术治疗室性心动过速与其他介入治疗方法的对比。

Ten-year trends in catheter ablation for ventricular tachycardia vs other interventional procedures in Australia.

机构信息

Department of Cardiology, Faculty of Medicine, Dentistry, and Health Science, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.

Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia.

出版信息

J Cardiovasc Electrophysiol. 2019 Nov;30(11):2353-2361. doi: 10.1111/jce.14143. Epub 2019 Sep 13.

Abstract

AIMS

Major technological and procedural advancements have reinvigorated catheter ablation as adjunctive therapy for drug-refractory ventricular tachycardia (VT). We examined temporal trends in VT ablations as compared to other interventional cardiovascular procedures namely, percutaneous coronary intervention (PCI) and atrial fibrillation (AF) ablation in Australia.

METHODS AND RESULTS

A retrospective review of procedural numbers for VT ablations, AF ablations, and PCI was performed from 2008/09-2016/17 the Australian Institute of Health, Welfare and Aging (AIHW), and Medicare Australia (MA) databases. Linear regression models were fitted to compare the trends in population-adjusted procedural numbers over the 10-year period. Data from the AIHW and MA sources respectively showed that (a) PCI had a 1.3% (AIHW data P = .15) and 1.8% (MA data P < .001) population-adjusted increment per year, (b) AF ablations had a 12.7% (P < .001) and 11.7% (P < .001) per year population-adjusted increment, and (c) VT ablations showed an 18% (P < .001) and 12.7% (P < .001) per year population-adjusted increment. Growth of PCI was increasing at a lower rate than AF ablations (P < .001 for both AIHW and MA sources). Growth of VT ablation was significantly higher than AF ablations and PCI (AIHW: 18% vs 12.7% [P = .004] and 1.3% per year [P < .001]).

CONCLUSION

Catheter-based VT ablation has increased significantly in Australia over the last decade, consistent with worldwide trends, and now surpassing all ablation procedures, including AF ablation and PCI for CAD. This data highlight the provision of additional resources to match the increasing demand for VT ablation procedures in Australia.

摘要

目的

主要技术和程序上的进步使导管消融作为药物难治性室性心动过速(VT)的辅助治疗方法重新焕发生机。我们检查了与其他介入性心血管程序(即经皮冠状动脉介入治疗(PCI)和心房颤动(AF)消融)相比,在澳大利亚 VT 消融的时间趋势。

方法和结果

对 2008/09 年至 2016/17 年澳大利亚卫生、福利和老龄化研究所(AIHW)和澳大利亚医疗保险(MA)数据库中 VT 消融、AF 消融和 PCI 的程序数量进行了回顾性审查。线性回归模型用于比较 10 年内人群调整后程序数量的趋势。来自 AIHW 和 MA 来源的数据分别显示:(a)PCI 的人群调整后每年增加 1.3%(AIHW 数据 P=0.15)和 1.8%(MA 数据 P<0.001);(b)AF 消融的人群调整后每年增加 12.7%(P<0.001)和 11.7%(P<0.001);(c)VT 消融显示人群调整后每年增加 18%(P<0.001)和 12.7%(P<0.001)。与 AF 消融相比,PCI 的增长速度较低(AIHW 和 MA 来源均 P<0.001)。VT 消融的增长速度明显高于 AF 消融和 PCI(AIHW:18%对 12.7%[P=0.004]和每年 1.3%[P<0.001])。

结论

在过去十年中,澳大利亚的导管基 VT 消融显著增加,与全球趋势一致,现在超过了所有消融程序,包括 AF 消融和 CAD 的 PCI。这些数据强调提供额外的资源以匹配澳大利亚对 VT 消融程序日益增长的需求。

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