波兰和欧洲皮下植入式心脏除颤器的应用——多中心注册研究结果的比较。
Utilization of Subcutaneous Cardioverter-Defibrillator in Poland and Europe-Comparison of the Results of Multi-Center Registries.
机构信息
Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-210 Gdansk, Poland.
Medical College, University of Rzeszow, 35-959 Rzeszow, Poland.
出版信息
Int J Environ Res Public Health. 2021 Jul 5;18(13):7178. doi: 10.3390/ijerph18137178.
The implantation of a subcutaneous cardioverter-defibrillator (S-ICD) may be used instead of a traditional transvenous system to prevent sudden cardiac death. Our aim was to compare the characteristics of S-ICD patients from the multi-center registry of S-ICD implantations in Poland with the published results of the European Snapshot Survey on S-ICD Implantation (ESSS-SICDI). We compared data of 137 Polish S-ICD patients with 68 patients from the ESSS-SICDI registry. The groups did not differ significantly in terms of sex, prevalence of ischemic cardiomyopathy, concomitant diseases, and the rate of primary prevention indication. Polish patients had more advanced heart failure (New York Heart Association (NYHA) class III: 11.7% vs. 2.9%, NYHA II: 48.9% vs. 29.4%, NYHA I: 39.4% vs. 67.7%, < 0.05 each). Young age (75.9% vs. 50%, < 0.05) and no vascular access (7.3% vs. 0%, < 0.05) were more often indications for S-ICD. The percentage of patients after transvenous system removal due to infections was significantly higher in the Polish group (11% vs. 1.5%, < 0.05). In the European population, S-ICD was more frequently chosen because of patients' active lifestyle and patients' preference (both 10.3% vs. 0%, < 0.05). Our analysis shows that in Poland, compared to other European countries, subcutaneous cardioverters-defibrillators are being implanted in patients at a more advanced stage of chronic heart failure. The most frequent reason for choosing a subcutaneous system instead of a transvenous ICD is the young age of a patient.
皮下植入式心律转复除颤器（S-ICD）可替代传统的经静脉系统，用于预防心源性猝死。我们旨在比较波兰多中心 S-ICD 植入登记处的 S-ICD 患者特征与已发表的欧洲 S-ICD 植入Snapshot 调查（ESSS-SICDI）的结果。我们比较了 137 例波兰 S-ICD 患者和 ESSS-SICDI 登记处的 68 例患者的数据。两组在性别、缺血性心肌病患病率、合并症和一级预防指征发生率方面无显著差异。波兰患者心力衰竭更严重（纽约心脏协会（NYHA）心功能分级 III 级：11.7% vs. 2.9%，NYHA 心功能分级 II 级：48.9% vs. 29.4%，NYHA 心功能分级 I 级：39.4% vs. 67.7%，均<0.05）。年轻（75.9% vs. 50%，<0.05）和无血管通路（7.3% vs. 0%，<0.05）更常作为 S-ICD 的指征。因感染而移除经静脉系统的患者在波兰组中比例显著更高（11% vs. 1.5%，<0.05）。在欧洲人群中，S-ICD 因患者的积极生活方式和患者偏好而更常被选择（均为 10.3% vs. 0%，<0.05）。我们的分析表明，与其他欧洲国家相比，波兰在慢性心力衰竭更晚期的患者中植入皮下除颤器。选择皮下系统而非经静脉 ICD 的最常见原因是患者较年轻。
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