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[无导线起搏器与传统起搏器对缓慢性心律失常患者生活质量改善的比较]

[Comparison of leadless pacemaker and conventional pacemaker for quality of life improvement in patients with bradyarrhythmias].

作者信息

Yu M, Li Y P, Zhou Y J, Shi D M

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart disease, Capital Medical University,Beijing 100029, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Mar 14;103(10):733-739. doi: 10.3760/cma.j.cn112137-20221114-02383.

Abstract

To compare the improvement in quality of life (QoL) after implantation of leadless pacemakers (L-PM) with that of conventional pacemakers (C-PM) in patients with slow-onset arrhythmias. A total of 112 patients who received pacemaker implantation for the first time at Beijing Anzhen Hospital from January 2020 to July 2021 were selected, including 50 leadless pacemakers (L-PM) and 62 conventional pacemakers (C-PM). Clinical baseline data were collected, pacemaker-related complications and SF-36 scores were recorded and followed up at 1, 3, and 12 months post-operatively; SF-36 questionnaires and additional questionnaires were completed to compare the quality of life of the 2 groups; and factors associated with the change in QoL from baseline to 1, 3 and 12 months post-operatively were analyzed using multiple linear regression models. The age of the 112 patients was (70.3±10.5) years, and 69 patients (61.6%) were male. The age of patients with L-PM and C-PM was (75.8±8.5) years and (67.5±10.4) years, respectively (0.004). In the L-PM group, 50 patients completed 1-, 3-, and 12-month follow-up. In the C-PM group, 62 patients completed the 1-month and 3-month follow-up, and 60 completed the 12-month follow-up. The C-PM group had a higher incidence of discomfort in the surgical area, impact of daily activities for the discomfort in the surgical area, and concern about heart or overall condition than the L-PM group on the additional questionnaire (all values0.05). After adjusting for age and SF-36 scores at baseline, at 12 month of follow-up, patients implanted with C-PM had lower values for quality of life PF, RP, SF, RE, and MH scores compared to patients implanted with L-PM, with beta values (95%) of -24.500 (-30.010--18.981), -27.118 (-32.997--21.239), -8.085 (-12.536--3.633), -4.839 (-9.437--0.241), -12.430 (-18.558--6.301), respectively (all values<0.05). L-PM is associated with better QoL in slow arrhythmias patients, and patients who received L-PM reported less activity limitations due to surgical discomfort and less emotional distress.

摘要

比较缓慢型心律失常患者植入无导线起搏器(L-PM)与传统起搏器(C-PM)后生活质量(QoL)的改善情况。选取2020年1月至2021年7月在北京安贞医院首次接受起搏器植入的112例患者,其中无导线起搏器(L-PM)50例,传统起搏器(C-PM)62例。收集临床基线资料,记录起搏器相关并发症及术后1、3、12个月的SF-36评分并进行随访;完成SF-36问卷及附加问卷以比较两组的生活质量;采用多元线性回归模型分析术后1、3、12个月QoL相对于基线变化的相关因素。112例患者年龄为(70.3±10.5)岁,男性69例(61.6%)。L-PM组和C-PM组患者年龄分别为(75.8±8.5)岁和(67.5±10.4)岁(P=0.004)。L-PM组50例患者完成了1、3、12个月的随访。C-PM组62例患者完成了1个月和3个月的随访,60例完成了12个月的随访。附加问卷显示,C-PM组手术区域不适、手术区域不适对日常活动的影响以及对心脏或整体状况的担忧发生率高于L-PM组(均P<0.05)。在对年龄和基线SF-36评分进行校正后,随访12个月时,植入C-PM的患者在生活质量PF、RP、SF、RE和MH评分方面的值低于植入L-PM的患者,β值(95%置信区间)分别为-24.500(-30.010-18.981)、-27.118(-32.997-21.239)、-8.085(-12.536-3.633)、-4.839(-9.437-0.241)、-12.430(-18.558~-6.301)(均P<0.05)。无导线起搏器与缓慢型心律失常患者更好的生活质量相关,接受无导线起搏器的患者因手术不适导致的活动受限和情绪困扰更少。

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