心律转复除颤器对室性心律失常的疗效评价

Evaluation of the efficacy of implantable cardioveter defibrillators for the treatment of ventricular arrhytbmias

目的评价80例植入型心律转复除颤器（ICD）的临床应用效果，分析植入ICD患者室性心律失常的发作情况以及ICD治疗恶性室性心律失常的疗效。方法对本院1996年8月至2008年1月来本院就诊定期随访、资料完整的植入了ICD患者进行回顾性临床分析。结果80例植入了ICD患者（其中11例为二次更换ICD），其中65例（81．25％）为各种器质性心脏病，以冠心病最为常见。随访4～62（26．96±18．97）个月中，72例患者（90％）发生室性心动过速和／或心室颤动，并成功接受ICD治疗，共发生心律失常事件1243次，启动治疗程序1854次，包括抗心动过速起搏成功治疗室速712次，低能量复律和高能量除颤转复治疗共266次。误识别治疗147次。68次心律失常事件在ICD启动治疗程序中自行终止，ICD未继续实施治疗。随访期间共有3例（3．75％）患者死亡。结论ICD能够有效地治疗室性心律失常。植入术后需要密切随访，根据情况及时调整工作参数。

Objective To evaluate the efficacy of implantable cardioverter defibrillator（ICD） in trea- ting malignant ventricular arrhythmias. Methods Observe the patients with ICD from Aug, 1996 to Jan, 2008 in Fuwai Hospital. Results During the period of 1996-2008, there were 80 patients accepted ICD implantation and the proportion with underlying diseases was 81.25%, coronary artery disease was the most common cause. Ventricular tachycardia and/or ventricular fibrillation（VT/VF） occurred in 90% cases and were detected and terminated by ICD devices. Conclusion ICD with tiered therapy function has high efficacy on the termination of ventricular tachyarrhythmias. It is important to follow up the patient and dynamically optimize the system of ICD.