Characterization of the PRAETORIAN score in Japanese patients undergoing subcutaneous implantable cardioverter-defibrillator implantation
Characterization of the PRAETORIAN score in Japanese patients undergoing subcutaneous implantable cardioverter-defibrillator implantation
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日本皮下植入式心脏复律除颤器植入患者的 PRAETORIAN 评分特征
DOI：
10.1016/j.jjcc.2022.06.014
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发表时间：
2022
期刊：
影响因子：
2.5
通讯作者：
Tomita H.
中科院分区：
文献类型：
--
作者：
Yamazaki K;Ishida Y;Sasaki S;Toyama Y;Nishizaki K;Kinjo T;Itoh T;Kimura M;Sakai S;Shikanai S;Sorimachi Y;Hamaura S;Tomita H.
PRAETORIAN评分用于评估植入位置和预测植入皮下植入型心律转复除颤器（S-ICD）患者的除颤成功率。然而，有用的PRAETORIAN评分为日本patients.MethodsWe评估有用的这个分数，这是由宽度的子线圈脂肪，子发电机脂肪，和前定位的S-ICD发电机由术后胸部X线，在连续100日本S-ICD植入患者[78名男性，中位年龄59（IQR 46.5-67.0）岁，中位体重指数（BMI）24.2（21.3-27.2）kg/m2]。结果中位PRAETORIAN评分为30（30-45）分，93例患者被归类为转换失败的低风险。其余7人处于中等风险。几乎所有患者都被归类为PRAETORIAN评分第二和第三步中的最佳脉冲发生器位置。观察到的唯一差异是第一步中的子弹簧圈脂肪的宽度。为了进一步评价其意义，将患者分为较厚组（子弹簧圈脂肪>1个弹簧圈宽度，n= 19）和较薄组（子弹簧圈脂肪≤1个弹簧圈宽度，n= 81）。较厚组的BMI和电击后阻抗均高于较薄组[分别为27.1（25.6-31.6）vs 23.1（20.9-25.7）kg/m2，p< 0.001，75（68-88）vs 63（55-74）Ω，p= 0.003]。在888（523-1418）天的中位随访期内，7例患者因自发性室性快速性心律失常接受了适当的电击治疗，这些患者均处于低风险状态。未观察到转换失败。不适当的休克（IAS）发生在11例患者中，并有IAS率之间的较厚的组（n= 2）和较薄的组（n= 9）（p= 0.747对数秩检验）。PRAETORIAN评分可用于评价日本S-ICD植入患者的转换失败。
BackgroundThe PRAETORIAN score was developed to evaluate the implant position and predict defibrillation success in patients implanted with a subcutaneous implantable cardioverter-defibrillator (S-ICD). However, usefulness of the PRAETORIAN score for Japanese patients is unknown.MethodsWe evaluated usefulness of this score, which was determined by width of sub-coil fat, sub-generator fat, and anterior positioning of the S-ICD generator by post-operative chest X-ray, in consecutive 100 Japanese S-ICD implanted patients [78 men, median age 59 (IQR 46.5–67.0) years, median body mass index (BMI) 24.2 (21.3–27.2) kg/m2].ResultsThe median PRAETORIAN score was 30 (30–45) and 93 patients were classified as a low risk of conversion failure. The remaining seven were at an intermediate risk. Almost all patients were classified as an optimal pulse-generator position in the second and third steps of the PRAETORIAN score. The only difference observed was in the width of sub-coil fat in the first step. To further evaluate its significance, patients were divided into the Thicker group (sub-coil fat >1 coil width,n= 19) and the Thinner group (sub-coil fat ≤1 coil width,n= 81). BMI and post-shock impedance were both higher in the Thicker group than in the Thinner group [27.1 (25.6–31.6) versus 23.1 (20.9–25.7) kg/m2,p< 0.001, and 75 (68–88) versus 63 (55–74) Ω,p= 0.003, respectively]. During the median follow-up periods of 888 (523–1418) days, 7 patients experienced appropriate shock therapy for spontaneous ventricular tachyarrhythmias, who were all at a low risk. No conversion failure was observed. Inappropriate shock (IAS) occurred in 11 patients, and there was no difference in IAS rate between the Thicker group (n= 2) and the Thinner group (n= 9) (p= 0.747 by log-rank test).ConclusionsMost Japanese patients were classified as at low risk of conversion failure. The PRAETORIAN score may be useful for the evaluation of conversion failure in Japanese S-ICD implanted patients.