植入型心律转复除颤器不恰当放电的临床分析

Clinical analysis of inappropriate shock of implantable cardioverter defibrillators

目的分析植入型心律转复除颤器（ICD）不恰当放电发生情况及常见原因。方法2001年11月至2007年10月植入ICD并长期随访的43例患者。通过定期随访查询ICD中存储的事件信息，根据腔内电图判断事件是否为不恰当放电。结果43例患者中有7例发生了96次不恰当放电。6例患者是室上性心动过速引起，1例是干扰引起。5例患者第1次不恰当放电发生在植入ICD后1年内。植入ICD前有心房颤动（房颤）病史是发生不恰当放电的独立预测因子。结论植入ICD前有房颤病史的患者较易出现不恰当放电，临床应多予以重视。

Objective Implantable cardioverter defibrillator （ICD） can effectively treat life- threatening ventricular arrhythmias. The most common side effect is inappropriate discharge. This study analyzes the incidence and causes of inappropriate discharges of ICD in our hospital. Methods Forty-three patients implanted with ICD in our hospital from November 2001 to October 2007 were involved in our study. Patients were followed-up regularly. All episodes recorded and stored in the ICD were analyzed. Results Seven of the 43 patients underwent ninety-six inappropriate discharges. Inappropriate discharges in six patients were caused by supraventricular tachyarrhythmias （SVT）. In one patient the discharge was caused by noise. Most inappropriate discharges occurred in the first year after implantation. The history of atrial fibrillation before implantation is an independent predictor of inappropriate discharges. Conclusions The incidence of inappropriate discharge is 16. 3% in our study and the most common cause is SVT. Most inappropriate discharges occur in the first year after implantation. Patients with atrial fibrillation history have a higher risk of inappropriate discharges.