全球精选文摘 - 与单腔除颤器相比，双腔植入型心律转复除颤器可减少房颤相关的临床不良事件：DATAS试验的亚组分析

Dual-chamber implantable cardioverter defibrillators reduce clinical adverse events related to atrial fibrillation when compared with single-chamber defibrillators: a subanalysis of the DATAS trial

Ricci RP, on behalf of DATAS study Investigators 2010/4/1 16:25:00

【发表评论】【全球专家评论】

打印| 推荐给好友

Europace, 2009,

专家评级：

★

循证评级：

View at Publisher

Aims:
The aim of the present analysis of the DATAS study was to compare the impact of dual- vs. single-chamber defibrillators on atrial fibrillation (AF) occurrence and AF-related clinical events in patients with Class I indication for implantable cardioverter defibrillators (ICDs) and no indication for dual-chamber pacing.

Methods and Results:
Three hundred and thirty-four patients were randomized, through a centralized assignment, to single-chamber ICDs, dual-chamber ICDs programmed as single-chamber ICDs, and dual ICDs with full diagnostics and AF prevention and therapy capabilities. The latter two groups in the first 8 months of the study, when the study design was that of a randomized parallel trial, were compared in the present analysis. The primary endpoint was composed by the following AF-related clinical events: permanent AF, AF-related hospitalizations, cardiac-embolic events, and inappropriate ICD shocks due to AF misclassification. Two hundred and twenty-three patients were available for this analysis, of whom 111 in the single-chamber-simulated group and 112 in the dual-chamber true group. Atrial fibrillation-related composite endpoint raw incidence was 9 of 111 (8.1%) in the single-chamber group vs. 1 of 112 (0.9%) in the dual-chamber group (P=0.0098 by Fisher's exact test). Single-chamber ICDs were associated with a significantly higher risk to develop the AF-related composite endpoint by Cox regression analysis (hazard ratio 8.25, 95% CI 1.03–65.96, P=0.047) and by the Kaplan-Meier survival analysis (log-rank test, P=0.047).

Conclusion:
Dual-chamber ICDs compared with single-chamber ICDs reduced the incidence of an endpoint composed by permanent AF, AF-related hospitalizations, and ICD shocks deemed inappropriate due to AF misclassification.

Figure 2: Kaplan–Meier freedom from atrial fibrillation-related composite endpoint in single- vs. dual-chamber groups. (Courtesy of Ricci RP, on behalf of DATAS study Investigators. Dual-chamber implantable cardioverter defibrillators reduce clinical adverse events related to atrial fibrillation when compared with single-chamber defibrillators: a subanalysis of the DATAS trial. Europace. 2009;11:587-593.)

请登录后发表评论，点击此处登录。

全部学科

疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

更多>>>

医学数据库