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Heart:心脏复律除颤器植入术后的长期并发症研究

2017-07-30 MedSci MedSci原创

植入式心律转复除颤器(ICD)降低了人群的死亡风险,但是,其也伴随着相关的危害。近期,一项发表在杂志Heart上的研究旨在描述其长期并发症和再手术率情况。此项研究使用加拿大不列颠哥伦比亚省提供的一项前瞻性、多中心登记册的相关数据,评估了长期再次手术和生存率的概率,累积发病率和预测因子。此项研究随访时间为2003年至2012年,共3410例首次(n = 1854)或二级预防(n = 1556)的IC

植入式心律转复除颤器(ICD)降低了人群的死亡风险,但是,其也伴随着相关的危害。近期,一项发表在杂志Heart上的研究旨在描述其长期并发症和再手术率情况。


此项研究使用加拿大不列颠哥伦比亚省提供的一项前瞻性、多中心登记册的相关数据,评估了长期再次手术和生存率的概率,累积发病率和预测因子。此项研究随访时间为2003年至2012年,共3410例首次(n = 1854)或二级预防(n = 1556)的ICD患者(平均63.3岁,男性81.7%),中位随访时间为34个月(单室n = 1069,双室n = 1905,双心室n = 436)。使用Cox回归模型定义不良结局的独立预测因子。

此项研究结果显示:每病人-年的整体再手术率为12.0%,相较于双室和双心室ICD,单室的概率较低(9.1%vs 12.5%vs. 17.8%)。其1年、3年和5年的Kaplan-Meier并发症估计(不包括发生器寿命)分别为:单室10.2%,16.2%和21.6%;双室11.7%,19.1%和27.4%,双心室15.9%,22.2%和24.7%。

心脏再同步治疗的早期并发症发生率最高。装置复杂性、年龄和心房颤动是并发症的关键决定因素。总体的1年、3年和5年的死亡率分别为5.4%、17.4%和32.7%。

在年轻患者中观察到,5年生存率接近普通人群的预期存活率(相对存活率= 0.96(0.90-0.98))。随着年龄的增长,观察到的生存率相对于预期而言稳步下降。

原始出处:
Hawkins NM, Grubisic M, et al. Long-term complications, reoperations and survival following cardioverter-defibrillator implant. Heart. 2017 Jul 26. pii: heartjnl-2017-311638. doi: 10.1136/heartjnl-2017-311638. 

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    2018-02-18 丁鹏鹏
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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 31 12:50:11 CST 2017, time=2017-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228430, encodeId=5bb1228430fa, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Mon Jul 31 10:09:16 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-08-10 jacob9231

    学习了谢谢分享

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 31 12:50:11 CST 2017, time=2017-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228430, encodeId=5bb1228430fa, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Mon Jul 31 10:09:16 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-08-01 slcumt
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    2017-08-01 jiyangfei
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style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Tue Aug 01 03:46:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439137, encodeId=ae50143913ea9, content=<a href='/topic/show?id=8e3a98396f2' target=_blank style='color:#2F92EE;'>#除颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98396, encryptionId=8e3a98396f2, topicName=除颤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Aug 01 03:46:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356440, encodeId=6bba135644076, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Aug 01 03:46:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228460, encodeId=a42222846088, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 31 12:50:11 CST 2017, time=2017-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228430, encodeId=5bb1228430fa, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Mon Jul 31 10:09:16 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-08-01 zhouqu_8
  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM66WRRAmeqIVSnDN88DpaJfEWzRZxg4yBbiaBmMRwcvViaA2C0sE0Ts3Lic24JSSI4YffujDtpnm0GTHpuiao9TytmNArrcYESnSXY/0, createdBy=7938104912, createdName=jacob9231, createdTime=Thu Aug 10 22:45:00 CST 2017, time=2017-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562643, encodeId=f4b21562643e7, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Tue Aug 01 03:46:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520389, encodeId=65171520389cd, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Tue Aug 01 03:46:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439137, encodeId=ae50143913ea9, content=<a href='/topic/show?id=8e3a98396f2' target=_blank style='color:#2F92EE;'>#除颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98396, encryptionId=8e3a98396f2, topicName=除颤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 31 12:50:11 CST 2017, time=2017-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228430, encodeId=5bb1228430fa, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Mon Jul 31 10:09:16 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-08-01 zhaojie88
  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 31 12:50:11 CST 2017, time=2017-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228430, encodeId=5bb1228430fa, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Mon Jul 31 10:09:16 CST 2017, time=2017-07-31, status=1, ipAttribution=)]
    2017-07-31 清风拂面

    谢谢分享,学习了

    0

  10. 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    2017-07-31 往日如昨

    学习了谢谢分享

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