CAJ | 학술논문

目的评价家庭监测在心脏起搏器、心脏再同步治疗(CRT)和植入型心律转复除颤器(ICD)中的临床应用价值.方法回顾性分析55例植入具有家庭监测功能的心血管植入型电子器械的患者,及通过家庭监测系统所获得的每日资料和报警的数据,分析信息的成功传输比例、起搏器阈值变化和心律失常发生情况.结果自2009年5月至2011年6月间浙江地区55例植入具有家庭监测功能的心血管植入型电子器械患者,双腔起搏器46例、CRT 5例、ICD 2例、心脏再同步治疗除颤器(CRT-D)2例,其中男39例,女16例,年龄40～86(70±10)岁.平均随访(320±163)d.共接收信息17430次,信息成功传输比例79.9％,发现异常事件399次,其中疾病相关事件216次(54％),系统相关事件183次(46％).双腔起搏器患者1个月内导线阈值不稳定相关事件较多,占总事件41.0％,双腔起搏器患者房性心律失常相关事件较多,占心律失常事件62.1％.5例CRT患者和2例CRT-D患者心律失常报警以室性早搏增多和CRT比例下降为主,占总事件38.2％,2例ICD患者术后多次发生室性心律失常事件.结论家庭监测是一种安全、可靠、有效的心血管植入型电子器械的监测设备.利用家庭监测系统传输的信息可以及时调整监控参数、治疗心律失常.
목적 평개가정감측재심장기박기、심장재동보치료(CRT)화식입형심률전복제전기(ICD)중적림상응용개치.방법 회고성분석55례식입구유가정감측공능적심혈관식입형전자기계적환자,급통과가정감측계통소획득적매일자료화보경적수거,분석신식적성공전수비례、기박기역치변화화심률실상발생정황.결과 자2009년5월지2011년6월간절강지구55례식입구유가정감측공능적심혈관식입형전자기계환자,쌍강기박기46례、CRT 5례、ICD 2례、심장재동보치료제전기(CRT-D)2례,기중남39례,녀16례,년령40～86(70±10)세.평균수방(320±163)d.공접수신식17430차,신식성공전수비례79.9％,발현이상사건399차,기중질병상관사건216차(54％),계통상관사건183차(46％).쌍강기박기환자1개월내도선역치불은정상관사건교다,점총사건41.0％,쌍강기박기환자방성심률실상상관사건교다,점심률실상사건62.1％.5례CRT환자화2례CRT-D환자심률실상보경이실성조박증다화CRT비례하강위주,점총사건38.2％,2례ICD환자술후다차발생실성심률실상사건.결론 가정감측시일충안전、가고、유효적심혈관식입형전자기계적감측설비.이용가정감측계통전수적신식가이급시조정감공삼수、치료심률실상.
Objective To evaluate the value of home monitoring in patients with cardiovascular implantable electronic devices(CIED).Methods There were 55 patients with CIED in our study.Data transmitted daily and automatically by a remote,Wireless Home MonitoringTM system (HM) were analyzed.Results Between May 2009 and June 2011,55 patients [39 males,mean age (70 ± 10) years] of pacemakers (n =45),cardiac resynchronization therapy (CRT,n =5) systems,implantable cardioverter defibrillators (ICD,n =2),and combined ICD + CRT(CRT-D) systems (n =2)were recruited in this study in Zhejiang.17 430 messages were transmitted successfully.Transmission success rate was 79.9％.The mean duration of monitoring was (320 ± 163)days.Three hundred and ninety-nine abnormal events were reported and 54％ of events were disease-related.Unstable threshold of leads was observed in 1-month interval and the 62.1％ arrhythmic events in patients with pacemaker were atrial arrhythmias.Increasing number of premature ventricular events/hours and lower percent ventricular resynchronization limit were observed in 5 patients with CRT and 2 patients with CRTD.Multiplied times of ventricular tachycardia and ventricular fibrillation were the majority events in 2 patients with ICD.Conclusions Home MonitoringTM system is safe and effective in patients with CIED in following-up procedure.The data from Home MonitoringTM system are helpful to detect and manage the abnormal events in time.