埋置心脏复律除颤器患者的随访与药物辅助治疗

Followup and Management for Patients With Implantable CardioverterDefibrillators

为了解埋藏式心脏复律除颤器（ＩＣＤ）埋置后病人及ＩＣＤ工作的情况，以便及时调整ＩＣＤ的诊断及治疗程序从而给予病人更适当的治疗，对８例接受ＩＣＤ治疗的病人分别在出院前及出院后每３～６个月进行一次随访观察。８例病人随访１１．４±７．０个月，共发生心律失常事件２５次。抗心动过速起搏（ＡＴＰ）治疗６７次，第１次成功２２次，占３２．８％。高能量除颤１０次，第１次成功６次，占６０．０％。总成功率９１．３％。１例病人室性心动过速发作频繁、１例病人ＩＣＤ不能有效终止心动过速、２例病人出现甲状腺功能障碍。经调整药物及ＩＣＤ工作方式后，心动过速控制良好。表明对接受ＩＣＤ治疗的病人进行定期随访十分重要，及时调整ＩＣＤ程序设置和辅以药物治疗，可提高ＩＣＤ治疗的成功率。

The results of the patients with implantable cardioverterdefibrillator(ICD) was investigated in order to give them a approprate treatment by changeing the programsetting and drug administration.Followup for 8 patients after ICD implantation was conducted before discharge from hospital and every 3～6 months after discharge.Results:Averaged period of followup was 11.4±7.0 months.Total arrhythmic events were 25 times,the success rate of antiarrhythmic pacing(ATP) and high energy defibrillation were 32.8%(22/67) and 60.0%(6/10) respectively.Of the patients,one had frequent ventricular tachycardia attack,one had a refractory response to ICD therapy,two presented thyrogenic disfunction and these problems were solved after regulating the setting and drug administration.Conclusion:Followup is important for patient with ICD.It is helpful to guide doctors to modify the work setting of ICD and drug administration in time which in turn to increase the success rate of ICD in terminating arrhythmic events.