第四代埋藏式自动复律除颤器的临床应用

The clinical experience of the fourth generation of implantable cardioverter defibrillator

2例冠心病,陈旧心肌梗塞并持续室性心动过速的病人,服用2～3种抗心律失常药无效而考虑埋藏式自动复律除颤器(ICD)治疗.术前电生理检查均诱发了持续室速,并了解了诱发和终止条件.经锁骨下静脉穿刺安装了第四代ICD.术后随访7～12个月中,2例均有室速发作而正确放电,但1例有窦性心动过速被误感知现象,经程序调整而消失.本文强调了适应症选择,术前电生理检查和术后随访的重要性.

2 cases of patients who accepting implantable cardioverter defibrillator(ICD) were reported. Both patients had recurrent ventricular tachycardia (VT) complicated with old myocardial infarction. Sustained VT was induced in the pre - operation electrophysioIogic(EP) study.The fourth generation of ICD were implanted.The working program of ICD was set up according to the result of EP study .During 7-12 months follow - up, both divices have discharged correctly to convert VT.One had a mis - detection of sinus tachycardia, which have never occur after changing the anti - tachycardia pacing program. The indication and importance of EP study and follow - up were discussed.