新型冠状病毒肺炎对植入心血管植入型电子器械患者的影响:单中心分析  

Impact of COVID-19 on patients with implanted cardiovascular implantable electronic devices: a single-center analysis

作　　者：周诗银 俞杉[1] 安亚平[1] 李隽[1] 龙向淑[1] 李孝勇 吴强[1] Zhou Shiyin;Yu Shan;An Yaping;Li Jun;Long Xiangshu;Li Xiaoyong;Wu Qiang(Department of Cardiology,Guizhou Provincial People′s Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院心内科,贵阳550002

出　　处：《中华心律失常学杂志》2022年第4期372-376,共5页Chinese Journal of Cardiac Arrhythmias

基　　金：贵州省高层次创新型人才培养计划项目(2016-4023);贵州省科技平台及人才团队计划项目(2017-5405)。

摘　　要：目的总结单中心近5年植入心血管植入型电子器械(CIED)的变化趋势,分析新型冠状病毒肺炎(COVID-19)疫情对CIED植入的影响。方法2016年1月至2020年12月在贵州省人民医院心内科行CIED植入或更换的患者1565例,男855例,女710例。年龄(70.6±12.5)岁,年龄范围8~97岁。回顾性分析患者的年龄、性别、诊断、器械类型、主要合并症等。COVID-19疫情暴发时期,观察每年该时段内CIED植入量的变化趋势,比较2020年与2019年该时段内患者的年龄、性别、住院费用、住院时长等情况。结果2016年至2020年,CIED新植入1259例,更换306例,其中男855例。年龄中位数73岁。CIED植入类型以心脏起搏器为主,心脏再同步治疗及植入型心律转复除颤器的植入比例逐年增加,植入除颤器作为心脏性猝死一级预防的比例为40.6%~63.3%。疫情暴发期间CIED的植入量明显减少,较2019年同期下降54.5%(18/33),其中永久性起搏器的植入量下降了64.3%(10/28)。与2019年同期相比,女患者比例下降,差异无统计学意义(31.8%对56.4%,χ^(2)=3.411,P=0.065),患者的年龄、住院时长、住院总费用均差异无统计学意义(P值分别为0.620、0.582、0.718)。结论COVID-19疫情影响了CIED的植入,对永久性起搏器植入的影响更为明显。Objective To summarize the change of cardiovascular implantable electronic device(CIED)implantation in Guizhou Provincial People’s Hospital in recent 5 years,and analyze the impact of COVID-19 epidemic on CIED implantation.Methods From January 2016 to December 2020,1565 patients(855 males and 710 females)underwent CIED implantation or replacement in the Department of Cardiology,Guizhou Provincial People’s Hospital.The mean age was(70.6±12.5)years,ranging from 8 to 97 years.Age,sex,diagnosis,type of instrument,major comorbidities were analyzed retrospectively.The COVID-19 epidemic outbreak period was divided,and the changes of CIED implantation amount in the period every year and the basic situation of patients included age,gender,diagnosis,the type of CIED,the main comorbidities in 2020 and 2019 were compared.Results We enrolled 1565 patients,of whom 1259 were newly implanted CIED and 306 were replaced(855 male cases,median age 73 years old).The proportion of cardiac resynchronization therapy and implantable cardiovascular defibrillator implantation was increased gradually.The most common type of CIED was atrioventricular sequential permanent pacemaker,and the most common causes of CIED implantation were atrioventricular block and sick sinus syndrome.The proportion of implantable defibrillator as primary prevention of sudden cardiac death fluctuated from 40.6%to 63.3%.During the period of COVID-19 outbreak epidemic,the number of CIED implantation decreased significantly,down 54.5%(18/33)compared with the same period in 2019,the number of pacemaker implantation decreased by 64.3%(10/28).Compared with the same period in 2019,the proportion of female patients decreased,and the difference was not statistically significant(31.8%vs.56.4%,χ^(2)=3.411,P=0.065).There was no significant change in the patient′s age,length of hospitalization and total hospitalization expenses(P=0.620,0.582,0.718).Conclusion The COVID-19 outbreak has affected the implantation of CIED,and the impact on the implantation of permanent pac

关 键 词：心脏起搏器 人工 心血管植入型电子器械 新型冠状病毒肺炎 植入型心律转复除颤器 心脏再同步治疗 

分 类 号：R563.1[医药卫生—呼吸系统] R541.7[医药卫生—内科学]