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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Pacemaker longevity: are we getting what we are promised?
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Pacemaker longevity: are we getting what we are promised?

机译：心脏起搏器的寿命：我们是否能兑现承诺？

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BACKGROUND: Although pacemaker manufacturers provide projections on longevity, these projections cannot be relied upon due to the assumptions of output parameters being far in excess of those programmed in clinical practice. OBJECTIVE: The purpose of this review was to compare the actual longevity to the calculated longevity of pacemakers based on battery cell characteristics taking into account individual programmed parameters, mode, degree of usage, and percent pacing. This was also compared to the manufacturers' own projected longevities. METHODS: Patients who had a pacemaker replaced between 1998 and 2003 were included (n = 124). Cell characteristics were obtained from manufacturers and programmed parameters were obtained at each visit. Stepwise calculations were done for each visit to find current drain during each interval, and then were used in a weighted average to find the total average lifetime current drain. This was subsequently used to find a calculated longevity for each pacemaker to be compared to the actual longevity observed. RESULTS: The pacemakers lasted 491+/-92 days (mean+/-SEM) less than calculated. There was also a difference between dual- and single-chamber devices (though not statistically significant). Moreover, it was found that there were significant differences between manufacturers. CONCLUSIONS: There appears to be a significant discrepancy between calculated and actual longevities, confirming that battery depletion occurs earlier than expected. This suggests that current drain expended for ancillary functions may be considerable. Another factor may be pre-implantation drain. Vigilance with programming of outputs, modes, sensors, heart rates, and ancillary functions could potentially extend longevity and postpone/obviate the need for costly repeat surgery with its attended risk of complications. Furthermore, the differences between manufacturers seem to parallel the clinical impressions.
机译：背景：尽管起搏器制造商提供了使用寿命的预测，但由于输出参数的假设远远超过临床实践中设定的参数，因此不能依赖这些预测。目的：本次审查的目的是根据电池的特性，将起搏器的实际寿命与计算出的寿命进行比较，并考虑到各个编程参数，模式，使用程度和起搏百分比。这也与制造商自己的预期寿命进行了比较。方法：包括1998年至2003年间更换过起搏器的患者（n = 124）。从制造商处获得电池特性，并在每次访问时获得编程参数。对每次访问进行逐步计算以找到每个间隔期间的电流消耗，然后将其用于加权平均值以找到总平均寿命电流消耗。随后将其用于查找每个起搏器的计算寿命，并将其与观察到的实际寿命进行比较。结果：起搏器的持续时间比计算的少491 +/- 92天（平均+/- SEM）。双腔和单腔设备之间也存在差异（尽管在统计学上不显着）。而且，发现制造商之间存在显着差异。结论：计算出的寿命与实际寿命之间似乎存在显着差异，这证实了电池耗尽的发生比预期的要早。这表明用于辅助功能的电流消耗可能很大。另一个因素可能是植入前的流失。对输出，模式，传感器，心率和辅助功能进行编程的警惕性可能会延长寿命，并推迟/避免了昂贵的重复手术的需要，因为它存在并发症的风险。此外，制造商之间的差异似乎与临床印象相似。

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