远程监测起搏器在缓慢性心律失常患者中的应用

Application of pacemaker with remote monitoring in the patients with chronic arrhythmia

目的探讨带远程监测功能的起搏器在缓慢性心律失常患者中的应用。方法 82例符合起搏器植入I或IIa类适应证的缓慢性心律失常患者分别接受带远程监测功能起搏器(A组)和常规起搏器(B组)植入,术后分别予远程监测和随访12个月(1、6、12个月进行常规诊室随访,患者明显不适时随访不受限制),评估指标为心血管事件发生情况及提前发现时间。结果 A组发现房性心律失常、室性心律失常、异常Q波改变及异常ST-T改变的提前时间均早于B组[(50.5±15.4)d vs(37.0±11.2)d、(62.7±13.9)d vs(39.5±10.1)d、(51.2±18.3)d vs(38.7±15.4)d、(49.4±17.6)d vs(34.6±12.2)d],两组比较差异均有统计学意义(P<0.01)。而两组对血栓事件的发现差异无统计学意义(P>0.05),均于门诊常规随访时发现。结论远程监测起搏器能够提前发现缓慢性心律失常患者心血管事件的发生情况,起到较好的预警和干预作用,值得临床推广。

Objective To investigate the application of pacemaker with remote monitoring in the patients with chronic arrhythmia. Eighty-two patients with chronic arrhythmia conforming to the indication of Type I or IIa of pacemaker Methods implantation were randomly divided into two groups（Group A： pacemaker with remote monitoring, Group B： conventional pacemaker）. After pacemaker implantation, the patients were subject to remote monitoring and routine follow-up for 12 months（Conduct conventional clinic follow-up in the 1st, 6th and 12 th month, and there was no limit for the follow-up if the patients had any obvious discomfort.）, respectively. The evaluation indicators are the occurrence of cardiovascular events and time for earlier identification. ResultsGroup A had an earlier identification of atrial arrhythmia, ventricular arrhythmia, abnormal Q wave changes and abnormal ST-T change than Group B [（50.5±15.4） d（37.0vs ±11.2） d,（62.7±13.9） d（39.5vs ±10.1） d,（51.2± 18.3） d vs（38.7±15.4） d and（49.4±17.6） d vs（34.6±12.2） d], and the difference was statistically significant（P〈0.01）. However, there was no difference in the identification of thrombotic events（P〉0.05）. ConclusionRemote monitoring application in cardiovascular implantation electronic devices can identify the occurrence of cardiovascular events in the patients with chronic arrhythmia and has good alarming and intervention effect, which is worth clinical application.