Kuridze Nika, Tsverava Mikheil, Verulava Tengiz
Faculty of Clinical and Translational Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, GEO.
Department of Rhythmology, Acad. G. Chapidze Emergency Cardiology Center, Tbilisi, GEO.
Cureus. 2024 Mar 30;16(3):e57261. doi: 10.7759/cureus.57261. eCollection 2024 Mar.
Assessing the quality of life serves as a crucial metric during various therapeutic or surgical procedures. The rise in cardiac electronic device implantations in recent years underscores the significance of evaluating the quality of life among such patients.
We conducted a study focusing on the quality of life of 438 patients with cardiac implantable electronic devices (cardiac pacemakers, cardioverter-defibrillators, cardiac resynchronization therapy devices). These patients were diagnosed with sick sinus syndrome, high-degree atrioventricular (AV) block, or severe heart failure (New York Heart Association (NYHA) classes III- IV (NYHA III-IV)), with left ventricular ejection fraction (LVEF) ≤ 35%, with/without complete left bundle branch block (QRS ≥ 130 μs), or with a history of ventricular tachycardia/ventricular fibrillation. The study utilized the EuroQol 5-Dimension 5-level (EQ-5D-5L) questionnaire and the EQ visual analog scale, which patients completed both prior to cardiac device implantation and during six post-implantation follow-up visits. The analysis of the research findings was conducted using the IBM SPSS Statistics software program (Armonk, NY).
Cardiac pacemaker implantation in patients with sick sinus syndrome and high-grade AV block demonstrated significant and highly reliable positive effects on quality of life concerning mobility, self-care, and usual activity. Similarly, cardiac resynchronization device implantation in individuals with severe heart failure with reduced LVEF and wide QRS showed significant positive effects in these areas. However, cardioverter-defibrillator implantation did not yield positive effects on these modules. Regarding pain/discomfort, neither pacemaker nor cardiac resynchronization device implantation resulted in improved quality of life, while there was a somewhat positive effect observed in the cardioverter-defibrillator group. In terms of anxiety/depression, pacemaker implantation in patients with sick sinus syndrome and high-degree AV block had a significant and highly reliable positive impact on quality of life. Additionally, relatively positive impacts were noted at various periods following cardioverter-defibrillator and cardiac resynchronization device implantations.
Cardiac implantable electronic devices play a crucial role not only in saving lives but also in positively impacting the quality of life of patients when appropriately selected.
在各种治疗或外科手术过程中，评估生活质量是一项关键指标。近年来心脏电子设备植入数量的增加凸显了评估此类患者生活质量的重要性。
我们开展了一项针对438例植入心脏可植入电子设备（心脏起搏器、心脏复律除颤器、心脏再同步治疗设备）患者生活质量的研究。这些患者被诊断为病态窦房结综合征、高度房室传导阻滞或严重心力衰竭（纽约心脏协会（NYHA）III-IV级（NYHA III-IV）），左心室射血分数（LVEF）≤35%，伴有/不伴有完全性左束支传导阻滞（QRS≥130μs），或有室性心动过速/心室颤动病史。该研究使用了欧洲五维度五水平（EQ-5D-5L）问卷和EQ视觉模拟量表，患者在心脏设备植入前以及植入后的六次随访中均完成了这些问卷和量表。研究结果的分析使用了IBM SPSS Statistics软件程序（纽约州阿蒙克）。
病态窦房结综合征和高度房室传导阻滞患者植入心脏起搏器对生活质量在活动能力、自我护理和日常活动方面显示出显著且高度可靠的积极影响。同样，左心室射血分数降低且QRS增宽的严重心力衰竭患者植入心脏再同步治疗设备在这些方面也显示出显著的积极影响。然而，植入心脏复律除颤器对这些模块没有产生积极影响。关于疼痛/不适方面，起搏器和心脏再同步治疗设备植入均未改善生活质量，而心脏复律除颤器组观察到了一定程度的积极影响。在焦虑/抑郁方面，病态窦房结综合征和高度房室传导阻滞患者植入起搏器对生活质量有显著且高度可靠的积极影响。此外，心脏复律除颤器和心脏再同步治疗设备植入后的不同时期也观察到了相对积极的影响。
心脏可植入电子设备不仅在挽救生命方面发挥着关键作用，而且在合理选择时对患者的生活质量也有积极影响。
