埋藏式心脏转复除颤器安置后电风暴的处理与预后

Management and prognosis of implantable cardioverter defibrillator with electrical storm

目的通过分析埋藏式心脏转复除颤器(ICD)患者的长期随访资料,总结电风暴(ES)的诱发因素、临床处理及预后。方法48例患者共植入50台ICD,ES定义为24hICD正确检测到≥3次室性快速性心律失常,并促发ICD电治疗。结果随访时间中位数为16.9个月。共6例发生了8次ES。常见诱因为严重感染、心力衰竭和肾功能衰竭等。通过纠正诱因,使用抗心律失常药物,能有效减少和避免ICD电治疗。ES发生后,死亡率明显增高。结论ICD患者发生ES有比较明确的诱发因素,并且ES具有一定的预后判断价值。

Objective The causes, management and pronosis of electrical storm（ES） were evaluated by analyzing data of patients with implantable cardioverter defibrillators （ICD） . Methods Fifty ICDs were implanted in forty-eight patients. The definition of ES was that the ICDs correctly detected three times or more ventricular tachyarrhythmia, and triggered electrical therapy. Results The median follow-up period was 16.9 months, and 2 patients were loss. 8 eases of ES were observed in 6 patients. The common causes of ES were severe infection, heart failure, and renal function insufficient. The management of ES included the treatment of the causes and anti-arrhythmia drugs. The mortality was increased in patients with ES. Conclusion In patients with ICD, ES has definite causes and a certain value in prognosis analysis.