RESUMEN
Introducción y objetivos. Se describe el análisis de la actividad con implantes y recambios de marcapasos remitidos en 2012 al Registro Español de Marcapasos, con especial referencia a la selección de los modos de estimulación. Método. Se basa en la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados. Se recibieron datos de 115 centros hospitalarios, con un total de 12.856 tarjetas. Se estima un consumo de generadores convencionales y resincronizadores de 745,8 y 53,1 unidades por millón de habitantes, respectivamente. Se utilizan cables con sistema de fijación activa en más del 70% de los casos, el 20% con protección para resonancia magnética. La indicación electrocardiográfica más frecuente es el bloqueo auriculoventricular (56%). Se estimula en modo VVI /R al 28% de los pacientes con enfermedad del nódulo sinusal. Conclusiones. Se estabiliza el uso de marcapasos convencionales y disminuyen los implantes de resincronizadores. El uso del sistema de fijación activa de los cables ya es mayoritario. Se confirma la mayor incidencia de implantes en los varones y a menor edad por mayor frecuencia de trastornos de conducción. La edad influye en la adecuación del modo de estimulación (AU)
Introduction and objectives. Our aim was to analyze the pacemaker implantations and replacements reported to the Spanish Pacemaker Registry in 2012 with special reference to the selection of pacing modes. Method. The analysis was based on information provided by the European Pacemaker Patient Identification Card. Results. Data were received from 115 hospitals, with a total of 12 856 cards. An estimated 745.8 pacemaker generators and 53.1 resynchronization devices were implanted per million population. Active fixation leads were implanted in more than 70% of the patients; of these leads, more than 20% were safe for use with magnetic resonance. The most common electrocardiographic indication for pacemaker implantation was atrioventricular block (56%). In all, 28% of the patients with sick sinus syndrome were paced in VVIR mode. Conclusions. The use of conventional pacemakers remained stable, whereas the implantation of resynchronization devices increased. Active fixation leads are now employed in most patients. The findings of this study confirm the higher incidence of implantation in men and at an earlier age due to the higher rate of conduction disorders. Age is a factor that influences the choice of the appropriate pacing mode (AU)
Asunto(s)
Humanos , Masculino , Femenino , Marcapaso Artificial/estadística & datos numéricos , Marcapaso Artificial/tendencias , Estimulación Cardíaca Artificial/estadística & datos numéricos , Estimulación Cardíaca Artificial/tendencias , Estimulación Cardíaca Artificial , Cardioversión Eléctrica/instrumentación , Cardioversión Eléctrica/métodos , Sociedades Médicas/ética , Sociedades Médicas/organización & administración , Sociedades Médicas/normas , Registros Médicos/legislación & jurisprudencia , Prótesis e Implantes/estadística & datos numéricos , Prótesis e Implantes , Cardioversión Eléctrica/normas , Cardioversión Eléctrica , ElectrocardiografíaRESUMEN
INTRODUCTION AND OBJECTIVES: Our aim was to analyze the pacemaker implantations and replacements reported to the Spanish Pacemaker Registry in 2012 with special reference to the selection of pacing modes. METHOD: The analysis was based on information provided by the European Pacemaker Patient Identification Card. RESULTS: Data were received from 115 hospitals, with a total of 12 856 cards. An estimated 745.8 pacemaker generators and 53.1 resynchronization devices were implanted per million population. Active fixation leads were implanted in more than 70% of the patients; of these leads, more than 20% were safe for use with magnetic resonance. The most common electrocardiographic indication for pacemaker implantation was atrioventricular block (56%). In all, 28% of the patients with sick sinus syndrome were paced in VVIR mode. CONCLUSIONS: The use of conventional pacemakers remained stable, whereas the implantation of resynchronization devices increased. Active fixation leads are now employed in most patients. The findings of this study confirm the higher incidence of implantation in men and at an earlier age due to the higher rate of conduction disorders. Age is a factor that influences the choice of the appropriate pacing mode.
Asunto(s)
Arritmias Cardíacas/terapia , Terapia de Resincronización Cardíaca/estadística & datos numéricos , Sistema de Conducción Cardíaco/anomalías , Marcapaso Artificial/estadística & datos numéricos , Sistema de Registros , Adulto , Anciano , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiología , Síndrome de Brugada , Trastorno del Sistema de Conducción Cardíaco , Terapia de Resincronización Cardíaca/métodos , Electrocardiografía , Electrodos Implantados , Diseño de Equipo , Seguridad de Equipos , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Retratamiento/estadística & datos numéricos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Sociedades Médicas , España , Resultado del TratamientoRESUMEN
Introducción y objetivos. Se describe el resultado del análisis de la actividad con marcapasos remitidos en 2011 al Registro Español de Marcapasos, con especial referencia a la distribución poblacional y la selección de los modos de estimulación. Métodos. Procesado de la información de la Tarjeta Europea del Paciente Portador de Marcapasos con una aplicación informática específica. Resultados. Se analiza la información de 115 centros hospitalarios, un total de 13.373 tarjetas, lo que corresponde al 38% de la actividad estimada. El consumo de generadores convencionales y dispositivos de resincronización fue de 738 y 56,2 unidades por millón habitantes, respectivamente. La media de edad de los pacientes que recibieron un implante fue 76,7 años. El 57,2% de los implantes y el 56,5% de los recambios se realizaron en varones. La mayoría de los implantes (38,7%) y recambios de generadores (41,9%) se produjeron en la franja de 80-89 años. El 99,7% de los cables utilizados eran bipolares; el 63%, con sistema de fijación activa. A más del 20% de los pacientes con bloqueo auriculoventricular o enfermedad del nódulo sinusal se los estimula en modo VVI/R pese a estar en ritmo sinusal. Conclusiones. Respecto a años previos, se ha estabilizado el uso de marcapasos convencionales y han aumentado los implantes de resincronizadores. Persiste la mayor incidencia de implantes en los varones y a menor edad. La edad y el grado de bloqueo se muestran influyentes en la adecuación del modo de estimulación (AU)
Introduction and objectives. To describe the results of the analysis of pacemaker implantations reported to the Spanish Pacemaker Registry in 2011, with particular reference to the population distribution and the selection of pacing modes. Methods. Information provided by the European Pacemaker Patient Identification Card was processed using a purpose-built computer application. Results. Data from 115 hospitals were analyzed, totaling 13 373 cards, representing an estimated 38% of implantations. The number of pacemaker generators and resynchronization devices implanted was 738 and 56.2 units per million population, respectively. The mean age of the patients who received a device was 76.7 years. Overall, 57.2% of first implantations and 56.5% of replacements were performed in men. Most implantations (38.7%) and generator replacements (41.9%) were performed in patients aged between 80 and 89 years. Of the pacemaker leads used, 99.7% were bipolar and 63% used an active fixation system. Overall, 20% of the patients with atrioventricular block or sick sinus syndrome were paced in VVI/R mode despite being in sinus rhythm. Conclusions. With respect to previous years, the use of conventional pacemakers remained stable and the implantation of resynchronization devices has increased. The number of implantation procedures continues to be higher in men and in younger patients. Age and the degree of blockage remain as factors influencing the appropriate choice of pacing mode (AU)
Asunto(s)
Humanos , Femenino , Anciano , Anciano de 80 o más Años , Marcapaso Artificial/tendencias , Marcapaso Artificial , Estimulación Cardíaca Artificial/métodos , Estimulación Cardíaca Artificial/normas , Estimulación Cardíaca Artificial , Sociedades Médicas/normas , Sociedades Médicas , Marcapaso Artificial/normas , Estimulación Cardíaca Artificial/tendencias , Sociedades Médicas/tendencias , Terapia de Resincronización Cardíaca/métodos , Dispositivos de Terapia de Resincronización CardíacaRESUMEN
INTRODUCTION AND OBJECTIVES: To describe the results of the analysis of pacemaker implantations reported to the Spanish Pacemaker Registry in 2011, with particular reference to the population distribution and the selection of pacing modes. METHODS: Information provided by the European Pacemaker Patient Identification Card was processed using a purpose-built computer application. RESULTS: Data from 115 hospitals were analyzed, totaling 13,373 cards, representing an estimated 38% of implantations. The number of pacemaker generators and resynchronization devices implanted was 738 and 56.2 units per million population, respectively. The mean age of the patients who received a device was 76.7 years. Overall, 57.2% of first implantations and 56.5% of replacements were performed in men. Most implantations (38.7%) and generator replacements (41.9%) were performed in patients aged between 80 and 89 years. Of the pacemaker leads used, 99.7% were bipolar and 63% used an active fixation system. Overall, 20% of the patients with atrioventricular block or sick sinus syndrome were paced in VVI/R mode despite being in sinus rhythm. CONCLUSIONS: With respect to previous years, the use of conventional pacemakers remained stable and the implantation of resynchronization devices has increased. The number of implantation procedures continues to be higher in men and in younger patients. Age and the degree of blockage remain as factors influencing the appropriate choice of pacing mode.
Asunto(s)
Marcapaso Artificial/estadística & datos numéricos , Sistema de Registros , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Remoción de Dispositivos , Falla de Equipo/estadística & datos numéricos , Femenino , Sector de Atención de Salud , Cardiopatías/terapia , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Sistemas de Identificación de Pacientes , Factores Sexuales , Sociedades Médicas , España/epidemiología , Adulto JovenRESUMEN
Introducción y objetivos. En este artículo se describe el análisis de los implantes y recambios de marcapasos remitidos al Registro Español de Marcapasos en 2010, con especial referencia a la selección de los modos de estimulación. Métodos. La recogida de datos se basa en la información de la Tarjeta Europea del Paciente Portador de Marcapasos, que se procesa mediante una aplicación informática específica. Resultados. Se recibió información de 101 centros hospitalarios, con un total de 11.648 tarjetas. Se estima un consumo de 738 generadores por millón de habitantes. Entre los varones hay mayor incidencia de implantes de marcapasos y a una media de edad más baja. El 95,5% de los cables de estimulación utilizados fueron bipolares, el 56% con sistema de fijación activa y el 60% en cavidad auricular. La indicación electrocardiográfica más frecuente es el bloqueo auriculoventricular, seguida de la enfermedad del nódulo sinusal. El 24% de los pacientes con bloqueo auriculoventricular y el 25,6% con enfermedad del nódulo sinusal se estimulan en modo VVI/R (el 12% de unos y otros entre los pacientes de 80 o menos años). Los dispositivos de resincronización cardiaca alcanzan 47 unidades por millón de habitantes; un 25,7% no tiene desfibrilador automático implantable asociado. Conclusiones. Persiste el aumento del consumo de generadores de marcapasos. Los cables de estimulación que se utilizan son bipolares, y en su mayoría son de fijación activa. La edad sigue siendo un factor influyente en la adecuación del modo de estimulación en las diversas afecciones. La elección del modo de estimulación se puede mejorar en más del 20% (AU)
Introduction and objectives. Our aim is to describe the analysis of the pacemaker implants and replacements reported to the Spanish Pacemaker Registry in 2010, with special reference to the selection of pacing modes. Methods. Data collection was based on the information provided by the European Pacemaker Patient Identification Card, which was processed using a specially designed computer application. Results. Information was received from 101 hospitals, covering a total of 11 648 cards. An estimated 738 pacemaker generators per million population were placed in 2010. The number of pacemaker implantations is higher and the mean age of the recipients lower among men. Overall, 95.5% of the pacemaker leads used were bipolar, 56% employed an active fixation system, and 60% were placed in atrium. The most common electrocardiographic indication was atrioventricular block, followed by sick sinus syndrome. Twenty-four percent of the patients with atrioventricular block and 25.6% of those with sick sinus syndrome are being paced in VVI/R mode (12% of the patients in each group are aged 80 years or under). Cardiac resynchronization device implantation has reached the level of 47 units per million population, 25.7% of which are not associated with implantable cardioverter defibrillators. Conclusions. The upward trend in the use of pacemaker generators continues. The pacemaker leads used are predominantly bipolar, and the majority are active fixation leads. Age remains a factor in the choice of the appropriate pacing mode for the different types of heart disease. This choice could be improved in more than 20% of the cases of pacemaker implantation (AU)
Asunto(s)
Humanos , Masculino , Femenino , Informes Anuales como Asunto , Estimulación Cardíaca Artificial/economía , Estimulación Cardíaca Artificial/métodos , Estimulación Cardíaca Artificial , Marcapaso Artificial/economía , Marcapaso Artificial/estadística & datos numéricos , Marcapaso Artificial , Sociedades Médicas/estadística & datos numéricos , Sociedades Médicas/tendencias , Estimulación Cardíaca Artificial/estadística & datos numéricos , Estimulación Cardíaca Artificial/tendencias , Marcapaso Artificial/clasificación , Marcapaso Artificial/normas , Marcapaso Artificial/tendencias , Sociedades Médicas/organización & administración , Sociedades Médicas/normasRESUMEN
INTRODUCTION AND OBJECTIVES: Our aim is to describe the analysis of the pacemaker implants and replacements reported to the Spanish Pacemaker Registry in 2010, with special reference to the selection of pacing modes. METHODS: Data collection was based on the information provided by the European Pacemaker Patient Identification Card, which was processed using a specially designed computer application. RESULTS: Information was received from 101 hospitals, covering a total of 11 648 cards. An estimated 738 pacemaker generators per million population were placed in 2010. The number of pacemaker implantations is higher and the mean age of the recipients lower among men. Overall, 95.5% of the pacemaker leads used were bipolar, 56% employed an active fixation system, and 60% were placed in atrium. The most common electrocardiographic indication was atrioventricular block, followed by sick sinus syndrome. Twenty-four percent of the patients with atrioventricular block and 25.6% of those with sick sinus syndrome are being paced in VVI/R mode (12% of the patients in each group are aged 80 years or under). Cardiac resynchronization device implantation has reached the level of 47 units per million population, 25.7% of which are not associated with implantable cardioverter defibrillators. CONCLUSIONS: The upward trend in the use of pacemaker generators continues. The pacemaker leads used are predominantly bipolar, and the majority are active fixation leads. Age remains a factor in the choice of the appropriate pacing mode for the different types of heart disease. This choice could be improved in more than 20% of the cases of pacemaker implantation.
Asunto(s)
Estimulación Cardíaca Artificial/métodos , Marcapaso Artificial/estadística & datos numéricos , Factores de Edad , Interpretación Estadística de Datos , Sector de Atención de Salud , Humanos , Sistemas de Identificación de Pacientes , Sistema de Registros , Reoperación , Factores Sexuales , EspañaRESUMEN
INTRODUCTION AND OBJECTIVES: This article describes the finding of an analysis of all pacemaker implants reported to the Spanish Pacemaker Registry in 2009. Particular attention is paid to patients' demographic characteristics and to the pacing modes selected for various electrocardiographic indications. METHODS: The information provided by the European Pacemaker Identification Card was analyzed using a specially developed computer program. RESULTS: Data were received from 106 centers, covering a total of 11,939 cards and corresponding to 35% of all pacemakers implanted. The average age of patients receiving pacemakers was 76.6 years. Overall, 58.4% of pacemakers were implanted in men. The largest number of electrocardiographic indications for a pacemaker was for third-degree atrioventricular block, which comprised 56% of all atrioventricular blocks. The VVIR pacing mode was used for 24.0% of patients with sick sinus syndrome and 23.5% with atrioventricular block. Over 50% of leads employed an active fixation system, and 65% were placed in the atrium. CONCLUSIONS: The trend of increasing pacemaker use continued in 2009, reaching 729 units per million population. Pacemaker implantation was more frequent in males, who received them at a slightly younger age than women. Age was a more significant determinant of inappropriate pacing mode selection than electrocardiographic abnormalities. Active fixation of pacemaker leads was used in more than 50% of cases.
Asunto(s)
Marcapaso Artificial/estadística & datos numéricos , Factores de Edad , Anciano , Bloqueo Atrioventricular/terapia , Estimulación Cardíaca Artificial , Electrodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Factores Sexuales , Síndrome del Seno Enfermo/terapia , España/epidemiologíaRESUMEN
Introducción y objetivos. Se describe el análisis de los implantes de marcapasos remitidos al Registro Español de Marcapasos de 2009, con especial referencia a la distribución poblacional y la selección de los modos de estimulación en las diversas indicaciones electrocardiográficas. Métodos. Procesamiento de la información aportada por la Tarjeta Europea del Paciente Portador de Marcapasos en sus diversos campos empleando una aplicación informática específica. Resultados. Se recibió información de 106 centros, con un total de 11.939 tarjetas, el 35% de todos los marcapasos implantados. La media de edad del paciente que recibió el implante era 76,6 años. El 58,4% de los implantes se hicieron en varones. El mayor número de las indicaciones electrocardiográficas de los implantes fueron los bloqueos auriculoventriculares de tercer grado; los bloqueos auriculoventriculares fueron el 56%. Se estimuló en modo VVI/R al 24% de los pacientes con enfermedad del nódulo sinusal y el 23,5% de aquellos con bloqueos auriculoventriculares. Los cables utilizados fueron bipolares y más del 50% con sistema de fijación activa, el 65% en la posición auricular. Conclusiones. En 2009 persiste la tendencia al aumento del consumo de generadores de marcapasos (729/millón de habitantes), con mayor incidencia en los varones y a una edad ligeramente inferior que en las mujeres. El factor edad es más determinante que la alteración electrocardiográfica en la inadecuada selección del modo de estimulación. La elección de fijación activa de los cables supera el 50% (AU)
Introduction and objectives. This article describes the finding of an analysis of all pacemaker implants reported to the Spanish Pacemaker Registry in 2009. Particular attention is paid to patients demographic characteristics and to the pacing modes selected for various electrocardiographic indications. Methods. The information provided by the European Pacemaker Identification Card was analyzed using a specially developed computer program. Results. Data were received from 106 centers, covering a total of 11,939 cards and corresponding to 35% of all pacemakers implanted. The average age of patients receiving pacemakers was 76.6 years. Overall, 58.4% of pacemakers were implanted in men. The largest number of electrocardiographic indications for a pacemaker was for third-degree atrioventricular block, which comprised 56% of all atrioventricular blocks. The VVIR pacing mode was used for 24.0% of patients with sick sinus syndrome and 23.5% with atrioventricular block. Over 50% of leads employed an active fixation system, and 65% were placed in the atrium. Conclusions. The trend of increasing pacemaker use continued in 2009, reaching 729 units per million population. Pacemaker implantation was more frequent in males, who received them at a slightly younger age than women. Age was a more significant determinant of inappropriate pacing mode selection than electrocardiographic abnormalities. Active fixation of pacemaker leads was used in more than 50% of cases (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Marcapaso Artificial/provisión & distribución , Marcapaso Artificial/estadística & datos numéricos , Marcapaso Artificial , Estimulación Cardíaca Artificial/estadística & datos numéricos , Estimulación Cardíaca Artificial , Sociedades Médicas/organización & administración , Sociedades Médicas/estadística & datos numéricos , Sociedades Médicas/normas , Electrocardiografía/estadística & datos numéricos , Bloqueo Cardíaco/epidemiología , Marcapaso Artificial/clasificación , Marcapaso Artificial/tendenciasRESUMEN
Introducción y objetivos. En este artículo se describe el resultado del análisis de los implantes y recambios de marcapasos remitidos en 2008 al Registro Español de Marcapasos. Métodos. La recogida de datos se basa en la información de la Tarjeta Europea del Paciente Portador de Marcapasos. Resultados. Se recibió información de 116 centros hospitalarios, con un total de 11.855 tarjetas que suponen el 36,3% de los marcapasos implantados. Se objetiva un notable aumento del número de unidades consumidas, alcanzando 708,3 por millón de habitantes. Existe una mayor incidencia de implantes de marcapasos y a una media de edad más baja en varones, correspondiendo a la década de los setenta el mayor número de implantes, con el 39,1% del total. Los bloqueos auriculoventriculares aparecen como la más frecuente de las indicaciones electrocardiográficas. En los cables utilizados, el empleo del sistema de fijación activa supone el 59,3% de los auriculares y el 37% de los ventriculares. Se observa una mejor selección del modo de estimulación, siendo la edad un factor determinante, como por ejemplo en la enfermedad del nódulo sinusal, en la que se utiliza el modo VVI/R en el 29% de pacientes mayores de 80 años frente al 14% en los de edad inferior. Conclusiones. La edad es un factor que se muestra influyente en la adecuación del modo de estimulación. Aumenta la selección del sistema de fijación activa, alcanzando el 44,5% de los cables utilizados. La estimulación auriculoventricular registra el más alto porcentaje de utilización de todos los años analizados (AU)
Introduction and objectives. This article describes the findings of an analysis of data on pacemaker implantations and replacements reported to the Spanish Pacemaker Registry during 2008. Methods. The data came primarily from information recorded on European Pacemaker Patient Identification Cards. Results. Data were received from 116 hospital units, which submitted a total of 11,855 identification cards representing 36.3% of all pacemakers implanted. There was a marked increase in the number of pacemaker units used, which rose to a rate of 708.3 per million inhabitants. The frequency of pacemaker implantation increased and the mean age of male patients decreased. The largest number of implantations were carried out in patients in their 70s, who comprised 39.1% of the total. The most frequent electrocardiographic indication was atrioventricular block. With regard to pacing leads, active fixation leads were used in the atrium in 59.3% of cases and in the ventricle in 37.9% of cases. There was an improvement in the choice of pacing mode, with age being a determining factor. For example, in sick sinus syndrome, the VVI/R mode was used in a 29% of patients aged over 80 years compared with 14% of those aged under 80 years. Conclusions. Age was found to be one factor influencing the selection of the most appropriate pacing mode. Active fixation leads were used more often, reaching 44.5% of leads implanted. Atrioventricular pacing was used in a greater percentage of cases than in any other time period covered by the pacemaker registry (AU)
Asunto(s)
Humanos , Registros de Enfermedades/estadística & datos numéricos , Bloqueo Atrioventricular/cirugía , Marcapaso Artificial , Distribución por Edad y Sexo , Estimulación Cardíaca Artificial/métodosRESUMEN
INTRODUCTION AND OBJECTIVES: The aim of this article was to report findings from the Spanish Pacemaker Registry on procedures carried out in 2007. The analysis includes details of patients' demographic characteristics, the type of procedure (i.e., implant or replacement), pacing mode, and the electrode and fixation systems used. METHODS: The data collected comprised all the information recorded on European Pacemaker Patient Identification Cards, which were submitted voluntarily in either electronic or paper form. RESULTS: The information received from 114 health-care centers included 11 360 cards, which covered 36.9% of all pacemakers thought to be implanted during 2007. Some 680.4 pacemakers were used per million inhabitants. Usage varied significantly between different Spanish autonomous regions, partly due to uneven ageing of the population. Some 25.3% of all procedures were to replace generators. The average age of patients undergoing a first implantation was 76.1 years, with a difference between the sexes: 75.4 years in men and 77.1 years in women. First implantations were carried out most often in patients in their 70s, who comprised 40% of the total, compared with other decades of life. There were more first implantations in men, who accounted for 57.9% of the total, due to a higher incidence of intraventricular conduction disturbance. In contrast, sick sinus syndrome was equally common in both sexes. Leaving aside patients with atrial tachyarrhythmia, it was observed that the VVI/R mode was used in 26.2% of those with sick sinus syndrome, 28% with atrioventricular block and 28.1% with intraventricular conduction disturbance. Age had a great influence on whether this pacing mode was selected. Almost all leads used were bipolar. The percentage using active fixation increased to 36.5%. The percentage of implants involving low-energy cardiac resynchronization therapy remained unchanged. CONCLUSIONS: The Spanish Pacemaker Registry received data on a highly representative sample of patients requiring cardiac pacing in 2007, which covered 11 360 device implantations or replacements. It was observed that the incidence of first implantations was influenced by sex, being greater in males, who underwent implantation at a younger age because conduction disturbances were more common. Age was one factor influencing the pacing mode selected for a range of electrocardiographic indications for pacing. Almost all leads implanted were bipolar. The percentage using active fixation continues to increase.
Asunto(s)
Arritmias Cardíacas/terapia , Estimulación Cardíaca Artificial , Marcapaso Artificial , Sistema de Registros , Anciano , Femenino , Humanos , Masculino , EspañaRESUMEN
Introducción y objetivos. En este artículo se presentan los resultados del Registro Español de Marcapasos correspondientes a la actividad realizada en el año 2007, analizándose tanto el tipo de proceso (implantes y recambios) como su distribución poblacional, modos de estimulación y los sistemas de cables-electrodos utilizados. Métodos. La recogida de datos se basa en la información que aporta la Tarjeta Europea del Paciente Portador de Marcapasos, la cual es remitida de forma voluntaria en formato magnético o mediante copia de la tarjeta. Resultados. Se recibió información de 114 centros hospitalarios, con un total de 11.360 tarjetas, que suponen el 36,9% de todos los marcapasos que se estima fueron utilizados. El número de unidades consumidas por millón de habitantes fue 680,4; se aprecia una significativa variación entre las diversas comunidades autónomas, en parte debido al desigual envejecimiento poblacional en ellas. El 25,3% de la actividad referida al registro corresponde a recambios de generadores. La media de edad de los pacientes que reciben su primer implante fue 76,1 años, con diferencias en función del sexo: 75,4 años en varones y 77,1 años en mujeres. La década en la que se objetiva un mayor número de primoimplantes corresponde a los 70 años, con el 40% del total. La frecuencia de primoimplantes fue significativamente superior en los varones (57,9%), por una mayor incidencia en éstos de los trastornos de la conducción; sin embargo, es similar en ambos sexos la enfermedad del nódulo sinusal. Excluidos los pacientes en taquiarritmia auricular, se aprecia que el 26,2% de los pacientes con enfermedad del nódulo sinusal, el 28% de los bloqueos auriculoventriculares y el 28,1% de los trastornos de la conducción intraventricular son estimulados en modo VVI/R. La edad es un factor muy influyente en la selección de este modo. La práctica totalidad de los cables endocárdicos utilizados son bipolares. Se percibe un aumento del porcentaje de los que utilizan un sistema de fijación activo, que supone el 36,5%. La estimulación para la terapia de resincronización ventricular de baja energía se mantiene estable en número total de implantes. Conclusiones. El Registro Español de Marcapasos recoge una muestra prospectiva muy representativa de la estimulación realizada en el año 2007, con un total del 11.360 implantes y recambios. Se objetiva que el sexo del paciente influye en la incidencia de los primoimplantes, que es mayor en los varones y a una edad más temprana debido a una mayor frecuencia de las alteraciones de la conducción en ellos. La edad es un factor influyente en la selección del modo de estimulación en las diversas indicaciones electrocardiográficas que originan el implante. Casi todos los cables utilizados son bipolares, y aumenta evolutivamente el porcentaje de los que utilizan un sistema de fijación activo (AU)
Introduction and objectives. The aim of this article was to report findings from the Spanish Pacemaker Registry on procedures carried out in 2007. The analysis includes details of patients' demographic characteristics, the type of procedure (i.e., implant or replacement), pacing mode, and the electrode and fixation systems used. Methods. The data collected comprised all the information recorded on European Pacemaker Patient Identification Cards, which were submitted voluntarily in either electronic or paper form. Results. The information received from 114 health-care centers included 11 360 cards, which covered 36.9% of all pacemakers thought to be implanted during 2007. Some 680.4 pacemakers were used per million inhabitants. Usage varied significantly between different Spanish autonomous regions, partly due to uneven ageing of the population. Some 25.3% of all procedures were to replace generators. The average age of patients undergoing a first implantation was 76.1 years, with a difference between the sexes: 75.4 years in men and 77.1 years in women. First implantations were carried out most often in patients in their 70s, who comprised 40% of the total, compared with other decades of life. There were more first implantations in men, who accounted for 57.9% of the total, due to a higher incidence of intraventricular conduction disturbance. In contrast, sick sinus syndrome was equally common in both sexes. Leaving aside patients with atrial tachyarrhythmia, it was observed that the VVI/R mode was used in 26.2% of those with sick sinus syndrome, 28% with atrioventricular block and 28.1% with intraventricular conduction disturbance. Age had a great influence on whether this pacing mode was selected. Almost all leads used were bipolar. The percentage using active fixation increased to 36.5%. The percentage of implants involving low-energy cardiac resynchronization therapy remained unchanged. Conclusions. The Spanish Pacemaker Registry received data on a highly representative sample of patients requiring cardiac pacing in 2007, which covered 11 360 device implantations or replacements. It was observed that the incidence of first implantations was influenced by sex, being greater in males, who underwent implantation at a younger age because conduction disturbances were more common. Age was one factor influencing the pacing mode selected for a range of electrocardiographic indications for pacing. Almost all leads implanted were bipolar. The percentage using active fixation continues to increase (AU)
Asunto(s)
Humanos , Marcapaso Artificial/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Estimulación Cardíaca Artificial/estadística & datos numéricos , Síndrome del Seno Enfermo/cirugía , Bloqueo Sinoatrial/cirugía , Sistema de Conducción Cardíaco/fisiopatología , Estudios Multicéntricos como AsuntoRESUMEN
INTRODUCTION AND OBJECTIVES: The aim of this report was to describe the results of an analysis of the data on pacemaker implantations reported to the Spanish Pacemaker Registry during 2006. Special emphasis was placed on sociodemographic characteristics and on the pacing modes implemented for different electrocardiographic indications. METHODS: The data collected comprised all the information recorded with the European Pacemaker Patient Identification Card. Special software was used for the analysis. RESULTS: Information was received from 105 centers and involved a total of 10,401 cards. It represented 35% of all pacemakers implanted during 2006. The majority of implantations (57.5%) were performed in males, and this applied to all age decades, except the 90s. The average age of patients who received a first implant was 75 years. Atrioventricular block accounted for the greatest number of electrocardiographic indications. Some 25% of patients with sinus node disease received VVI/R pacing despite remaining in sinus rhythm. In addition, 1.5% of implanted devices provided cardiac pacing for ventricular resynchronization, and did not have an associated defibrillator function. Almost all the leads used were bipolar, with only 0.6% being unipolar. In addition, 35.2% of leads were active-fixation leads, while 24.3% of generator used throughout the year were for pulse generator replacement. Some 2.4% of generator replacements were due to erosion or infection. CONCLUSIONS: The number of pacemaker implantations and the incidence of conduction disturbance were both greater in males. Correspondingly, first implantations were carried out at a slightly younger age in males. The age decade during which the greatest number of pacemaker implantations was carried out was the 70s, followed by the 80s. Age was one of the factors that influenced the suitability of the pacing mode. In a significant percentage of patients, the pacing mode was inappropriate. The use of active-fixation electrodes continues to increase.
Asunto(s)
Bloqueo Cardíaco/terapia , Marcapaso Artificial/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Cardiología/estadística & datos numéricos , Femenino , Encuestas de Atención de la Salud/estadística & datos numéricos , Humanos , Masculino , Distribución por Sexo , Sociedades Médicas/estadística & datos numéricos , EspañaRESUMEN
Introducción y objetivos. Se describe el resultado del análisis de los implantes de marcapasos remitidos al Registro Español de Marcapasos correspondientes al año 2006. Se hace especial énfasis en la distribución poblacional y en los modos de estimulación utilizados en las diversas indicaciones electrocardiográficas. Métodos. La recogida de la información es la que aporta la Tarjeta Europea del Paciente Portador de Marcapasos en sus diversos campos. Se utiliza una aplicación informática específica para su explotación. Resultados. Se recibió información de 105 centros, con un total de 10.401 tarjetas, lo que supone el 35% de todos los marcapasos implantados. La incidencia de implantes es superior en los varones, con un 57,5%, y lo es en todas las décadas de la vida, a excepción de los 90 años. La media de edad del paciente que recibe el primer implante fue de 75 años. El mayor número de las indicaciones electrocardiográficas corresponde a los bloqueos auriculoventriculares. El 25% de los pacientes con enfermedad del nódulo sinusal se estimulan en modo VVI/R a pesar de permanecer en ritmo sinusal. La estimulación para terapia de resincronización ventricular, sin asociar capacidad de desfibrilación, supone el 1,5% de los implantes. Casi la totalidad de los cables utilizados fueron bipolares, sólo un 0,6% unipolares. El porcentaje de fijación activa en los cables fue del 35,2% y el de recambios de generadores, el 24,3% de los consumidos en el año. En el 2,4% de los recambios la causa fue la erosión o infección. Conclusiones. Hay un mayor número de implantes de marcapasos y una mayor incidencia de trastornos de la conducción en los varones; en éstos, el primer implante es a una edad ligeramente inferior. La década con mayor número de implantes corresponde a los 70 años, seguida de los 80. La edad es un factor influyente en la correcta adecuación del modo de estimulación. Un porcentaje significativo de pacientes estimulados lo son en un modo no idóneo. Sigue aumentando la fijación activa en los cables utilizados (AU)
Introduction and objectives. The aim of this report was to describe the results of an analysis of the data on pacemaker implantations reported to the Spanish Pacemaker Registry during 2006. Special emphasis was placed on sociodemographic characteristics and on the pacing modes implemented for different electrocardiographic indications. Methods. The data collected comprised all the information recorded with the European Pacemaker Patient Identification Card. Special software was used for the analysis. Results. Information was received from 105 centers and involved a total of 10,401 cards. It represented 35% of all pacemakers implanted during 2006. The majority of implantations (57.5%) were performed in males, and this applied to all age decades, except the 90s. The average age of patients who received a first implant was 75 years. Atrioventricular block accounted for the greatest number of electrocardiographic indications. Some 25% of patients with sinus node disease received VVI/R pacing despite remaining in sinus rhythm. In addition, 1.5% of implanted devices provided cardiac pacing for ventricular resynchronization, and did not have an associated defibrillator function. Almost all the leads used were bipolar, with only 0.6% being unipolar. In addition, 35.2% of leads were active-fixation leads, while 24.3% of generator used throughout the year were for pulse generator replacement. Some 2.4% of generator replacements were due to erosion or infection. Conclusions. The number of pacemaker implantations and the incidence of conduction disturbance were both greater in males. Correspondingly, first implantations were carried out at a slightly younger age in males. The age decade during which the greatest number of pacemaker implantations was carried out was the 70s, followed by the 80s. Age was one of the factors that influenced the suitability of the pacing mode. In a significant percentage of patients, the pacing mode was inappropriate. The use of active-fixation electrodes continues to increase (AU)