王洁,褚松筠,王玉玲,范芳芳,盛琴慧,蒋捷,高澜,李康,陈尔冬,金汉,贺鹏康,夏驭龙,周菁

• 1:北京大学第一医院心内科

摘要(Abstract)：

目的探讨新型冠状病毒肺炎(COVID-19)疫情期间植入式心脏自动复律除颤器(ICD)患者随访情况和不良心血管事件的变化。方法回顾北京大学第一医院自2019年1月24日至2020年7月16日随访的ICD患者人群,研究组定义为2020年1月24日至7月16日随访ICD患者,与对照组定义为疫情前同期(2019年1月24至7月16日)及研究组自身既往2019年7月24日至2020年1月16日对比随访方式和不良心血管事件发生情况。结果研究组ICD患者66例,其中42例(63.6%)电话随访;对照组59例患者全部诊室随访。研究组患者发生包括电击、心力衰竭加重、心脏原因入院、移植及臆测报警、起搏和除颤阈值升高、电量提前耗竭的事件共22例次。电击共147频次。对照组仅发生5例次事件,电击7频次。Poisson回归证实研究组不良心血管事件和器械相关不良事件发生风险有近4倍升高[相对风险(RR)3.66,95%可信区间(CI):1.44～9.29,P=0.006],总的电击风险升高达17倍(RR 17.58,95%CI8.44～36.60,P<0.001)。研究组与既往自身对照,患者在疫情期间不良事件也显著增加,且均主诉焦虑恐惧,而无心肌缺血,药物不依从等,亦未感染COVID-19。结论 ICD患者疫情期间精神心理状态值得关注,加强远程随访指导和心理干预可能有助于减少该类患者不良心血管事件的发生。

关键词(KeyWords)： 新型冠状病毒肺炎;植入式心脏自动复律除颤器;心理应激

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目：心脑血管疾病高危人群综合筛查与防控及卫生经济学研究(2017YFC1307704)

作者(Author): 王洁,褚松筠,王玉玲,范芳芳,盛琴慧,蒋捷,高澜,李康,陈尔冬,金汉,贺鹏康,夏驭龙,周菁

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