家庭监测系统在双腔起搏器植入患者中的多中心注册研究

摘要

Objective:Remole moniloring of implanlable cardiovascular device has been working as an important Lool for ensuring the optimal palienl care. Our study evaluated the benefit of home monitoring (HM) system in patients with pacemaker implantation.rnMethods: A total of 628 patients with dual chamber pacemaker implantation between February 2009 to December 2010 from 97 centers in China were enrolled. Daily transmitted HM information was analyzed for a 180-day period,and the abnormality report was defined by disease and device related events. The majority of disease related events were atrial fibrillation ( AF) and ventricular arrhythmia. Office follow-up was conducted at 3 and 6 months after pacemaker implantation in all patients.rnResults:There were 13/628 (2. 1%) patients without transmitted information and 137/615 (22.3%) without abnormal report. The HM system in rest 478 (77. 7% ) patients gave out disease related warning which was reported earlier than 3 or 6 months of their regular clinical visit. There were 141 patients had at least one report of AF episode,and the AF burden decreased significantly during a 180-day period,P<0. 05.rnConclusion: HM is a feasible and reliable remote monitoring system, it may detect abnormalities at the early stage for both disease and device related events;and it is especially helpful for early detection and treatment of AF in patients with dual chamber pacemaker implantation.%目的:评价家庭监测系统(HM)在植入双腔起搏器患者中的临床应用.方法:连续入选2009- 03至2010-12在全国97家医院植入德国Biotronic公司具有家庭监测功能的起搏器患者,共628例.应用远程无线家庭监测系统每日自动传输起搏器信息,特殊报警事件随时传送.所有信息进行分析,将异常报警事件分为两类:疾病相关事件和系统相关事件;前者主要包括房性和室性心律失常,植入后3个月、6个月对所有入选患者进行常规诊室随访.结果:628例患者中,13例患者一直没有信息传输(2.1%),其余615例患者有137例患者没有异常事件的报警(22.3%),其余478例(77.7%)均可见异常报警事件;HM发现异常事件的时间均早于3个月和6个月门诊随访时发现相应事件的时间.房颤事件中共141例记录到至少一次房颤发作,且6个月随访期间,房颤平均负荷逐渐而显著性降低(P<0.05).结论:对于植入双腔起搏器的患者,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,特别是对房颤进行早期诊断与及时治疗,并可能给病人带来临床长远益处.