2013～2015年湖北省心脏器械植入统计分析

Current trend in the use of cardiac implantable electronic devices in Hubei province:from 2013 to 2015

目的分析湖北地区2013~2015年心脏植入器械的应用现状。方法收集2013~2015年湖北省心脏起搏器、心脏再同步化治疗(CRT)和埋藏式心脏转复除颤器(ICD)的应用数据,分析3年间的变化趋势。结果 2013~2015年,湖北地区心脏起搏器植入量呈增长趋势,2014年和2015年分别增长了1.08%和7.65%;双腔起搏器和频率应答功能的比例逐年增加,单腔心室按需起搏器植入逐年减少(分别为40.65%、37.82%、36.48%);而适应证构成比相近。CRT的植入量也呈逐年增长,2014年和2015年的增长率分别为26%和8.73%;以非缺血性心脏病和左束支阻滞患者植入为主(分别为80%、80.95%、71.53%和75%、84.92%、77.37%);NYHA心功能I级患者逐渐增多(分别为1%、2.38%、8.03%)。ICD植入总量未见持续增长,2014年增长了20%,2015年下降了15.79%,主要用于SCD二级预防和器质性心脏病患者。结论既往3年间,湖北地区心脏起搏器和CRT治疗的量和质均有所提高,但是ICD治疗发展缓慢,心脏性猝死预防工作仍较艰巨。

Objective To provide comprehensive information on the use of cardiac implantable electronic device in Hubei province from 2013 to 2015. Methods We collected the application data of pacemaker, cardiac resynchro- nization therapy （CRT）, and implantable cardioverter defibrillator （ICD） in Hubei province from 2013 to 2015, and analyze the change trend. Results There was a slight increase in the absolute numbers of pacemak6r implants, with increase rate of 1.08% in 2014 and of 7.65% in 2015; the ratio of dual chamber pacemaker and frequency re- sponse function were increased, and the ratio of single ventricular inhibited pacemaker was reduced （the percentage was 40.65%, 37.82%, 36.48%, respectively）; however, the constituent ratio of indications between 3 years had no change. The implantation amount of CRT was increased in 2014 and 2015, with growth rate of 26 % and 8.73 %, re spectively; the majority of cases had non-ischemic heart disease and left bundle branch block （the percentage was 80%, 80.95%, 77.53% and 75%, 84.92%, 77.37%, respectively）; the proportion of patients with NYHAI level was gradually increased （the percentage was 1%, 2.38%, 8.03%, respectively）. The amount of ICD implants showed no sustained growth, increased by 20% in 2014 and fell by 15.79% in 2015, mainly for the second preven- tion and patients with organic heart disease. Conclusion In the past 3 years, the amount and quality of pacemaker and CRT implantation have been improved in Hubei province, however, the development of ICD is also slow, and the prevention of cardiac sudden death is still arduous.