Early complications and long-term outcomes of patients treated with a subcutaneous cardioverter-defibrillator: temporal trends and clinical implications of the anaesthetic strategies adopted at implant.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Donisi Luca, Kerkouri Fawzi, Marquié Christelle, Probst Vincent, Algalarrondo Vincent, Al Amoura Alaa, Badoz Marc, Bastard Emilie, Behar Nathalie, Bertaux Géraldine, Bessière Francis, Bordachar Pierre, Bouzeman Abdeslam, Cellarier Gilles, Chabert Jean-Pierre, Champ-Rigot Laure, Clerici Gaël, Da Costa Antoine, Defaye Pascal, Deharo Jean-Claude, Delahaye Camille, Demasles Christian, Eschalier Romain, Fauchier Laurent, Gaty Denis, Gorka Hervé, Goujeau Cyril, Guenancia Charles, Guiot Aurélie, Hermida Alexis, Heurtebise Isabelle, Hourdain Jérôme, Jacon Peggy, Jesel Laurence, Jourda François, Laredo Mikael, Lebon Alain, Leclercq Christophe, Lesaffre François, Litalien Jean, Loose Christophe, Mansourati Vincent, Maury Philippe, Mechulan Alexis, Milhem Antoine, Miralles Aurélien, Mizon-Gérard Frédérique, Mondoly Pierre, Moubarak Ghassan, Pasquié Jean-Luc, Perrot David, Peyrol Mickaël, Quentin Anne, Sadoul Nicolas, Strik Marc, Vannesson Claire, Victor Frédéric, Zanutto Aude, Boveda Serge, Marijon Eloi, Garcia Rodrigue
Аннотация
METHODS AND RESULTS: The nationwide, single-arm, observational HONEST cohort study included all patients implanted with an S-ICD (EMBLEM™, Boston Scientific) in France between 2012 and 2019. GA was characterised by controlled unconsciousness with airway management, while non-GA included all alternative techniques. Among 4924 patients, 1041 (21.1%) underwent non-GA. The proportion of non-GA use increased from 2.5% to 26.9% between 2012 and 2019 (P < 0.001). Patients undergoing implantation under non-GA tended to be older (51 ± 14 vs. 50 ± 15 years), had lower left ventricular ejection fraction (41 ± 16 vs. 43 ± 17%), and fewer secondary prevention indications (33 vs. 38%) (all P < 0.01). The 30-day complication rate was 3.4% in the non-GA group (vs. 3.7% in the GA group; P = 0.85). At follow-up, the incidence of overall complications (4.29 events per 100 person-years for non-GA vs. 4.73 for GA; P = 0.937), reintervention (1.21 vs. 1.62; P = 0.963), inappropriate shocks (2.88 vs. 2.78; P = 0.782), and all-cause mortality (2.93 vs. 2.56; P = 0.938) were similar between groups. Multivariable analysis confirmed that there were no differences across outcomes (all P values >0.1).
CONCLUSION: The anaesthesia strategy used for S-ICD implantation was not associated with poorer short- or long-term clinical outcomes, supporting non-general anaesthesia as a feasible alternative in appropriately selected patients.
CLINICALTRIALS.GOV ID: NCT05302115.