摘要
目的探讨家庭监测(HM)功能在埋藏式心脏转复除颤器(ICD)患者随访中的作用及意义。方法分析15例行HM型ICD植入患者的临床资料,与术后传统诊室随访方式相对比,评价远程HM获得的起搏系统参数的可靠性,并分析不同类型的报警信息,通过电话指导或必要时诊室随访的方式进行处理。结果 15例出院前HM方法与同一时间诊室随访方法所测定的右室除颤电极感知数值(r=0.97,P<0.01)、起搏阻抗数值(r=0.92,P<0.01)及除颤阻抗数值(r=0.98,P<0.01)有强相关性。随访(283.9±271.3)天,网上传输中观察到200次报警事件,其中临床相关事件共报警121次,较常规诊室随访提前发现临床事件(77.5±44.5)天,及时发现了电风暴,电极脱位和ICD误诊断,误放电等不良事件。12例(80%)通过电话远程调整治疗方案,3例(20%)提前诊室随访。结论 ICD患者通过HM功能进行术后随访是安全可靠的,通过HM可提前发现起搏系统异常及临床事件,利于及时调整治疗方案,优化术后的管理。
Objective To investigate the effect and the significance of home monitoring（HM） during the follow-up of high risk patients with implantable cardioverter defibrillator （ICD）. Methods Fifteen high risk patients who implanted with HM function of ICD were enrolled in this study. Compared with the conventional office visits, the parameters of defib- rillator device and the different types of remote alert messages delivered by HM were analyzed and then dealt with by remote telephone suggestion or by office visits back to hospital if necessary. Results In 15 patients, the lead parameters a- chieved by office visits were compared by remote HM before discharge , there were significant correlations in the sensitivity of defibrillator leads, the pacing impendence and defibrillation impendence（P〈0. 01 ）. 200 alert messages were detected by the HM during a mean follow-up of （283.9±271.3） days, including 121 clinical relative transmissions, and HM could find the clinical events earlier than conventional office visits for mean （ 77.5±44.5 ） days, such as electrical storm, lead dislocation and false diagnosis and inappropriate shock. Among all the patients, the alert messages of 12 patients （ 80% ） were dealt with by remote telephone suggestion and the other 3 patients were requested to the office visits ahead of schedule. Conclusions HM is a safe and reliable method during the follow-up of ICD patients. The function of HM could enhance discovery, facilitate the decisions timely and optimize the management of ICD.
出处
《中国心脏起搏与心电生理杂志》
2014年第4期308-311,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
