二例三台埋藏式心脏复律除颤器的长期随访观察

LongTerm FollowUp for 2 Patients with 3 Piece of Implantable Cardioverter Defibrillators

２例恶性室性心律失常患者接受埋藏式心脏复律除颤器（ＩＣＤ）治疗，分别对其进行了４２，５４个月随访。ＩＣＤ储存资料证实心律失常事件１４８次，启动治疗程序２８次。其中电击除颤１２次，采用抗心动过速起搏转复１４次，均为首次成功，成功率１００％；发生误放电２次，占治疗程序的７．１％（２／２８）。其余１２０次事件自行终止。术后口服奎尼丁可减少室性心动过速的发生，缩短发作时间。其中１例已更换ＩＣＤ，原导管系统仍符合使用条件。误放电原因与突发性标准未设置及设置不当有关。患者对电击的不适感与ＩＣＤ电击条件无关，系术后心理障碍所致。

Two patients with malignant ventricular arrythmia received implantable cardioverterdefibrillator was followed up 42,54 months respectively.The storage data revealed 148 episodes of arrythmic events was detected by ICD. The treatment programs were triggered 28 times.In which,electrical defibrillation cardioversion was given 12 times and 14 times of ATP cardioversion were used.The successful rate was 100 percent.All terminated successfully by the first treatment.Wrong discharge occurred twice which was 7.1%(2/28) of total treatment programs.The other 120 times of arrythmic events were nonsustained which were terminated spontaneously.Oral administration of Qinidine was given after implantation to decrease ventricular tachycardia and shorten its duration.One patient changed ICD.The original catheter system TB could be used continuously.The reason for wrong discharge was related to nonpresetting and wrong presetting of the criterion for sudden onset.The patients feeling of discomfort towards electric shock had become more and more significant.This was caused by postoperative psychological disturbance and wasnt related to ICD cardioversion condition.