植入型心律转复除颤器安置后电风暴的临床观察

Clinical observation of patients with implantable cardioverter defibrillator with electrical strom

目的探讨植入型心律转复除颤器(ICD)安置后患者心律失常电风暴的诱发因素及临床处理。方法接受ICD治疗的35例患者,应用体外程控仪调出ICD存储记录,对24h发作2次以上及ICD抗快速室性心律失常治疗情况进行分析。结果平均随访(33±19)个月,ICD记录4例术后出现7次心律失常电风暴。其中1例室速68阵ATP转复成功,1例术后3个月1h内室颤20阵均经ATP、除颤治疗终止。结论 ICD患者发生电风暴的明确诱发因素有:心肌缺血、心力衰竭和焦虑等。通过纠正诱因,使用抗心律失常药物能减少和避免ICD治疗,定期随访和及时调整参数是必要的。

Objective To observe the causes management of electrical storm by analyzing data of patients with implantable cardioverter defibrillator（ICD）.Methods Patients were treated with ICDs.Interrogation of the ICD memory was used to detect tow times or more ventricular tachyarrhythmia and therapy.Results They were followed up（33±19）months.7 times of electrical storm were observed in 4 patients.The common causes of electrical storm were myocardial ischemic,heart failure and anxiety.The management of electrical storm included the treatment of the causes and anti-arrhythmia drugs.Conclusion In patients with ICD,electrical storm has definite causes.Following up is important.Reprogramming some of the parameters of ICD is necessary.