远程数据传输在慢快综合征患者术后急性期随访中的应用

Application of remote data transmission in postoperation acute phase follow-up in patients with bradycardia-tachycardia syndrome

目的了解远程数据传输对慢快综合征患者起搏器术后急性期随访中的应用价值。方法纳入2009年8月至2012年8月明确诊断为慢快综合征并植入永久性起搏器的患者120例,按植入起搏器是否具有远程数据传输功能将患者分为对照组(n=68)和远程监测组(n=52)。按照随访方案进行随访,分析两组有意义随访[随访时进行了起搏参数调整和(或)药物的调整]及非常规随访(患者因不适、担心等任何原因在随访方案以外的时间主动到医院进行的随访)率的差别及非常规随访的原因。结果在起搏器植入术后3个月内,对照组有20例(29.4%)就诊,远程监测组有30例(57.7%)得到医生的复诊建议,其中29例到医院就诊,两组非常规随访率有显著统计学差异(P<0.01)。对照组中18例(26.4%)患者进行了有意义随访,远程监测组27例患者进行了有意义的随访(51.9%),两组有意义随访率有显著统计学差异(P<0.01)。对照组首次随访40%是由于心慌不适感觉就诊。术后3个月内收到的监测组患者报警信息主要是因为高心室率(59.6%)和频繁的模式转换(51.9%)。结论起搏器远程数据传输可及时发现慢快综合征患者起搏术后起搏参数及药物调整需求,指导患者到医院进行有意义随访。

Objective To get to know the application value of remote data transmission in follow-up period in the patients with bradycardia-tachycardia syndrome after permanent pacemaker （PPM） implantation. Methods The patients （n=120） were divided, according to whether PPM having remote data transmission, into control group （n=68） and remote monitoring group （n=52）. All patients were given follow-up based on a follow-up plan. The difference in the rate of significant follow-up （pacemaker parameters and/or drug being regulated during follow- up period） and rate of non-routine follow-up （patients coming to hospital for follow-up because of discomfortable and worry outside of follow-up plan time）, and causes of non-routine follow-up were analyzed. Results Within 3 months after PPM, there were 20 patients （29.4%） visited doctor in control group, and 30 （57.7%） got the suggestion from doctor and 29 visited doctor in remote monitoring group. The rate of non-routine follow-up had statistical difference between two groups （P〈0.01）. There were 18 patients （26.4%） had significant follow-up in control group and 27 （51.9%） in remote monitoring group. The rate of significant follow-up had statistical difference between two groups （P〈0.01）. In control group, 40% of patients came to visit doctor due to palpitation in the first follow-up. After PPM for 3 months, the alarm information received from remote monitoring group was mainly high ventrieular rate （59.6 %） and frequent mode switching （51.9%）. Conclusion The remote data transmission of PPM can find in time the demands of regulating pacemaker parameters and drugs in the patients with bradycardia-tachycardia syndrome, and guide them to get significant follow-up in hospital.