天津胸科医院10年心脏植入装置情况总结分析

10-years trends of cardiovascular implantable electronic device implantation in Chest hospital of Tianjin

目的:总结2001-2010年胸科医院心脏植入装置的类型、植入病因、植入部位及其变化趋势,分析与国外差异的原因。方法:分析10年来安置心脏植入装置患者的病因、年龄、心脏疾病类型对起搏装置选择的变化趋势,心室电极类型和心室电极位置情况。结果:(1)10年来在胸科医院共安置心脏植入装置2 826例,病窦综合征(SSS)及房室传导阻滞(AVB)仍为起搏器安置的主要原因,双腔起搏器为主要类型;(2)起搏类型及电极位置的选择越来越符合生理性起搏的理念;(3)特殊疾病的起搏适应征扩展,心脏再同步化治疗(CRT)及植入型心律转复除颤器(ICD)所占比例增加,但预防性ICD置入较少;(4)间隔起搏及螺旋电极数量明显升高。结论:随着对生理性起搏概念的再认识,起搏器类型的选择及起搏方式越来越符合生理性起搏模式,但猝死高危人群的预防性装置植入仍较发达国家有较大差距,经济条件及医生的认识是主要原因。

Objective： To evaluate contemporary trends of clinical characteristics,etiologies,associated with the procedure in patients undergoing cardiovascular implantable electronic device（CIED） implantation between 2001 and 2010 in Tianjin Chest hospital.Methods： The etiologies,ages,the type and the change from people＇s choice of CIED,position,type of ventricular lead were analysed.Results：（1）This study included 2 826 patients with all kinds of underlying disease requiring CIED implantation,first or replacement.Sick sinus syndrome（SSS） and atrioventricular block（AVB） was the leading cause of device implantation.The most frequently used pacing modes was DDD.（2） The choice about the type of CIED and electrode position more and more accorded with the concept to physiological pacing.（3）The ratio of non-bradyarrhythmias was increasing steadily due to expanding guidelines for the implantation of CIED.Cardiac resynchronization therapy and implantable cardiac defibrillator（ICD） were also used in selected patients with a trend of increasing with statistical significance,but the number of the ICD being used the primary prevention was few.（4）The number of septal pacing and screw active-fixation lead using were increasing significantly in the latest three years（P 0.05）.Conclusion： With people＇s recognition to the concept of physiological pacing,people more and more mimick physiological activity of the heart about pacing type and mode.However,the numbers of devices used for preventing sudden death are more lesser compared with the developed countries as the result of the economy and cognition.