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皮下埋め込み型除細動器のオーバーセンシングにおける心電図変化の臨床的影響
http://hdl.handle.net/10191/0002001079
http://hdl.handle.net/10191/00020010793304b0e8-f1f8-4154-b2d4-6fbb06d42cbc
名前 / ファイル | ライセンス | アクション |
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||||||
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公開日 | 2023-07-26 | |||||||||
タイトル | ||||||||||
言語 | en | |||||||||
タイトル | Clinical impact of ECG changes on oversensing of subcutaneous implantable cardioverter-defibrillators | |||||||||
タイトル | ||||||||||
言語 | ja | |||||||||
タイトル | 皮下埋め込み型除細動器のオーバーセンシングにおける心電図変化の臨床的影響 | |||||||||
言語 | ||||||||||
言語 | eng | |||||||||
キーワード | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Oversensing | |||||||||
キーワード | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Subcutaneous implantable cardioverter-defibrillator (S-ICD) | |||||||||
キーワード | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Inappropriate shocks (IASs) | |||||||||
キーワード | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | ECG change | |||||||||
資源タイプ | ||||||||||
資源 | http://purl.org/coar/resource_type/c_db06 | |||||||||
タイプ | doctoral thesis | |||||||||
アクセス権 | ||||||||||
アクセス権 | open access | |||||||||
アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||
著者 |
袴田, 崇裕
× 袴田, 崇裕
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抄録 | ||||||||||
内容記述タイプ | Abstract | |||||||||
内容記述 | BACKGROUND Inappropriate shocks delivered by subcutaneous implantable cardioverter-defibrillators (S-ICDs) are most frequently caused by cardiac oversensing. However, the predictors for oversensing of S-ICD remain unclear. OBJECTIVE We aimed to investigate the predictors for oversensing of S-ICD, especially clinical impact of an electrocardiographic (ECG) change. METHODS We retrospectively enrolled 99 consecutive patients who underwent S-ICD implantation between 2013 and 2021. Oversensing events were defined as inappropriate charge of the capacitors induced by cardiac or noncardiac signals other than tachycardia. RESULTS During a median follow-up period of 34 months (interquartile range 20-50 months), 11 of 99 patients (11%) experienced 34 oversensing events and 4 patients (4%) received inappropriate shocks during their events. Six patients exhibited ECG changes (bundle branch block, 3; ventricular pacing, 1; inverted T wave, 1; poor R-wave progression, 1) during the follow-up period. Oversensing events were observed in 4 of 6 patients with ECG change (67%), and 3 patients underwent S-ICD removal because of inevitable shock. Contrastingly, of the remaining patients without ECG change, all 7 patients who experienced oversensing events could continue using S-ICD with the reprogramming sensing vector and/or restriction of excessive exercise. Logistic regression analysis showed that lower voltage of Sokolow-Lyon ECG (V1S+V5R) was the predictor of oversensing in patients without ECG change. When the cutoff value was 2.1 mV, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.7%, 62.7%, 15.7%, and 98.1%, respectively. CONCLUSION Unavoidable oversensing resulting in S-ICD removal is caused by ECG change. Oversensing in patients without ECG change can be managed. | |||||||||
言語 | en | |||||||||
内容記述 | ||||||||||
内容記述タイプ | Other | |||||||||
内容記述 | Heart Rhythm. 2022, 19(10), 1704-1711. | |||||||||
言語 | en | |||||||||
DOI | ||||||||||
識別子タイプ | DOI | |||||||||
関連識別子 | https://doi.org/10.1016/j.hrthm.2022.05.037 | |||||||||
権利 | ||||||||||
言語 | en | |||||||||
権利情報 | © 2022 Heart Rhythm Society. All rights reserved. | |||||||||
学位名 | ||||||||||
言語 | ja | |||||||||
学位名 | 博士(医学) | |||||||||
学位授与機関 | ||||||||||
学位授与機関識別子Scheme | kakenhi | |||||||||
学位授与機関識別子 | 13101 | |||||||||
言語 | ja | |||||||||
学位授与機関名 | 新潟大学 | |||||||||
言語 | en | |||||||||
学位授与機関名 | Niigata University | |||||||||
学位授与年月日 | ||||||||||
学位授与年月日 | 2023-03-23 | |||||||||
学位授与番号 | ||||||||||
学位授与番号 | 甲第5141号 | |||||||||
学位記番号 | ||||||||||
内容記述タイプ | Other | |||||||||
内容記述 | 新大院博(医)第1132号 | |||||||||
言語 | ja |