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JACC:植入式心脏去纤颤器的远程监控临床效果

2015-05-14 崔倩 译 MedSci原创

背景:植入式心脏除颤器(ICD)的远程监控(RM)是一种将成熟的技术整合到临床实践中的方法。最近的一项随机对照试验(RCT)和几个大型设备数据库的研究已经证明了与那些接受传统的 in-office(IO)随访相比,ICD患者接受RM具有强大的生存优势。    目的:本研究旨在用随机对照试验系统进行系统的文献回顾和荟萃分析,进而对比IO和RM。   

背景:植入式心脏除颤器(ICD)的远程监控(RM)是一种将成熟的技术整合到临床实践中的方法。最近的一项随机对照试验(RCT)和几个大型设备数据库的研究已经证明了与那些接受传统的 in-office(IO)随访相比,ICD患者接受RM具有强大的生存优势。
    
目的:本研究旨在用随机对照试验系统进行系统的文献回顾和荟萃分析,进而对比IO和RM。
    
方法:通过搜索电子数据库和参考文献目录找到那些接受或没有接受RM的ICD患者的临床疗效。数据由9个随机对照试验得出,包括6469例患者,其中的3496例患者随机接受RM,2973例患者接受IO随访。
    
结果:在RCT设置中,对于全因死亡率,RM表现出临床疗效与IO随访临床效果相比较(比值比[OR]:0.83;P=0.285),心血管疾病的死亡率(OR:0.66; P=0.103),住院率(OR:0.83; P=0.196)。然而,通过传输的日常核查结果,3期试验使用家庭监护的全因死亡率被指出有所降低(OR:0.65; P=0.021)。虽然RM和IO患者受到任何ICD休克的可能性是类似的(OR:1.05; P =0.86),但RM患者的不适当休克几率显著降低(OR:0.55; P=0.002)。
    
结论:随机临床试验的荟萃分析表明,RM和IO随访与患者的安全和生存相关,RCTs中使用日常传输验证带来了潜在的生存利益。RM优势包括更快速的临床事件检测和更少的不适当休克。

原始出处:

Nirmalatiban Parthiban,Adrian Esterman,Rajiv Mahajan,Darragh J. Twomey,et al.Remote Monitoring of Implantable Cardioverter-Defibrillators,J Am Coll Cardiol,2015.5.13

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    2016-01-30 villahu
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    2016-03-05 hbwxf
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    2015-05-17 huaxipanxing

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2047810, encodeId=738d204e810f0, content=<a href='/topic/show?id=2ce79445562' target=_blank style='color:#2F92EE;'>#远程监控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94455, encryptionId=2ce79445562, topicName=远程监控)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Feb 04 02:49:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1748719, encodeId=ea4d1e48719c1, content=<a href='/topic/show?id=4087626564c' target=_blank style='color:#2F92EE;'>#植入式#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62656, encryptionId=4087626564c, topicName=植入式)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cdca36191722, createdName=villahu, createdTime=Sat Jan 30 10:49:00 CST 2016, time=2016-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853338, encodeId=098318533380d, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Mar 05 04:49:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23939, encodeId=7218239398a, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Sun May 17 20:13:00 CST 2015, time=2015-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325026, encodeId=4e0b132502644, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484470, encodeId=ab8d14844e072, content=<a href='/topic/show?id=889e2284233' target=_blank style='color:#2F92EE;'>#临床效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22842, encryptionId=889e2284233, topicName=临床效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fab7968641, createdName=12498d2fm53(暂无昵称), createdTime=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520260, encodeId=d049152026079, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, 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=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2047810, encodeId=738d204e810f0, content=<a href='/topic/show?id=2ce79445562' target=_blank style='color:#2F92EE;'>#远程监控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94455, encryptionId=2ce79445562, topicName=远程监控)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Thu Feb 04 02:49:00 CST 2016, time=2016-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1748719, encodeId=ea4d1e48719c1, content=<a href='/topic/show?id=4087626564c' target=_blank style='color:#2F92EE;'>#植入式#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62656, encryptionId=4087626564c, topicName=植入式)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cdca36191722, createdName=villahu, createdTime=Sat Jan 30 10:49:00 CST 2016, time=2016-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853338, encodeId=098318533380d, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Mar 05 04:49:00 CST 2016, time=2016-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23939, encodeId=7218239398a, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Sun May 17 20:13:00 CST 2015, time=2015-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325026, encodeId=4e0b132502644, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484470, encodeId=ab8d14844e072, content=<a href='/topic/show?id=889e2284233' target=_blank style='color:#2F92EE;'>#临床效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22842, encryptionId=889e2284233, topicName=临床效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9fab7968641, createdName=12498d2fm53(暂无昵称), createdTime=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520260, encodeId=d049152026079, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, 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=Sat May 16 01:49:00 CST 2015, time=2015-05-16, status=1, ipAttribution=)]
    2015-05-16 jiyangfei
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