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家庭监测系统在心脏再同步治疗患者中的多中心注册研究

Effect of home monitoring on cardiac resynchronization therapy: a multi-center registration study of home monitoring system in China

摘要:

目的 评价远程无线家庭监测系统(home monitoring system,HM)在心力衰竭进行再同步治疗(CRT)患者中的临床应用.方法 连续入选2009年3月~2010年12月在全国30家医院植入百多力(Biotronic)公司具有HM功能的CRT患者,共73例.应用HM系统每日自动传输CRT信息,特殊报警事件随时传送.植入后3、6个月对所有患者进行常规诊室随访.结果 73例患者中,4例(5.5%)一直没有信息传输,5例没有异常事件的报警,其余64例(92.7%)均可见异常报警事件.异常报警事件分为两类:疾病相关事件(包括房性心律失常事件、室性心律失常事件、CRT双心室起搏频率过低等)占85%,系统相关事件(包括导线阻抗异常,感知功能异常)占15%.HM发现异常事件的时间均早于3、6个月门诊随访时发现相应事件的时间,且6个月时发生的疾病相关事件数明显低于3个月时.结论 对于心力衰竭植入CRT的患者,HM是一项安全可靠的远程监测方法,可以早期发现疾病相关事件及起搏系统相关异常,并可给患者带来临床长远益处.

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abstracts:

Objective Remote device monitoring of implantable cardiovascular devices has emerged as an important tool to ensure optimal patient care.This registration study was to evaluate the benefit of home monitoring(HM) in patients with cardiac resynchronization therapy (CRT).Methods Between February 2009 to December 2010,73 patients from 30 centers in China with biventrical pacemaker implantation were enrolled in this study.Daily transmissions were analyzed over a 180 day period.Office follow-ups were scheduled at 3 and 6months after implantation.Results From HM data,totally one hundred abnormal events were reported in sixtyfour patients.The majority of events were disease-related (85%),including atrial arrhythmia,ventricular arrhythmia and lower biventricular pacing percentage,etc.The other events were device-related (15%).All the events detection occurred earlier by HM than by the regular follow-up in three and six months.The abnormal events detected in six months were less than that in three months.Conclusion HM system is a feasible and reliable method which could early detect the abnormal events in the heart failure patients with CRT implatantion.This system is helpful to manage the patients effectively.

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