Department of Cardiology, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK.
School of Cardiovascular Medicine and Sciences, King's College London, James Black Centre, London SE5 9NU, UK.
Europace. 2023 Mar 30;25(3):940-947. doi: 10.1093/europace/euac281.
There is little evidence of the impact of syncope in implantable cardioverter-defibrillator (ICD) patients in routine community hospital care. This single-centre retrospective study sought to evaluate the incidence and prognostic significance of syncope in consecutive ICD patients.
Data were collected on consecutive patients undergoing first ICD implantation between January 2009 and December 2019. The primary endpoints were the first occurrence of all-cause syncope, all-cause mortality, and all-cause hospitalization. Multivariate Cox proportional hazard models were used to identify risk factors associated with syncope and to analyse the subsequent risk of mortality and hospitalization. 1003 patients (58% primary prevention) were included in the final analysis. During a mean follow-up of 1519 ± 1055 days, 106 (10.6%) experienced syncope, 304 died (30.3%), and 477 (47.5%) were hospitalized for any cause. In an analysis adjusted for baseline variables, the first occurrence of syncope was associated with a significantly increased risk of mortality (HR 2.82, P < 0.001) and the first occurrence of hospitalization (HR 2.46, P = 0.002).
Syncope in ICD recipients is common and associated with a poor prognosis irrespective of baseline variables and ICD programming. The occurrence of syncope is associated with a significant increase in the risk of mortality and hospitalization.
在常规社区医院护理中，关于植入式心脏复律除颤器（ICD）患者晕厥的影响证据有限。本单中心回顾性研究旨在评估连续 ICD 患者晕厥的发生率和预后意义。
收集了 2009 年 1 月至 2019 年 12 月期间首次植入 ICD 的连续患者的数据。主要终点为全因晕厥、全因死亡率和全因住院的首次发生。多变量 Cox 比例风险模型用于确定与晕厥相关的危险因素，并分析随后的死亡率和住院风险。最终分析纳入了 1003 例患者（58%为一级预防）。在平均 1519±1055 天的随访期间，106 例（10.6%）发生晕厥，304 例死亡（30.3%），477 例（47.5%）因任何原因住院。在调整基线变量的分析中，晕厥的首次发生与死亡率（HR 2.82，P<0.001）和首次住院（HR 2.46，P=0.002）的风险显著增加相关。
ICD 受者晕厥很常见，与基线变量和 ICD 编程无关，预后不良。晕厥的发生与死亡率和住院风险的显著增加相关。
