摘要
目的评估对于曾有急性心肌梗死的室性心动过速（VT）患者,导管消融（RA）减少植入式心脏转复除颤器（ICD）放电转律治疗的疗效和安全性。方法计算机检索Pubmed、EMbase、Cochrane图书馆、中国生物医学文献光盘数据库、中文科技期刊全文数据库、CNKI数字图书馆,纳入RA＋ICD和单独使用ICD对比治疗VT患者的随机对照临床试验,对纳入的研究进行质量评价和Meta分析。结果共纳入2篇最近发表在国外一流杂志上面的临床随机对照研究,一篇发在《新英格兰杂志》,另外一篇发在《柳叶刀》。RA＋ICD组纳入116例患者,其中有23例（20%）因为再发VT或者心室颤动（Vf）而进行了ICD放电转律治疗;ICD组纳入119例患者,其中有49例（41%）因为再发VT或者Vf而进行了ICD放电转律治疗。Meta分析结果显示,RA＋ICD的组合相对于单独运用ICD来说,需要进行ICD放电转律治疗的人数较少,OR=0.33,95%CI（0.18~0.61）,P=0.000 4。结论目前研究认为射频消融可能可减少需进行ICD放电转律治疗的人数,以后需要更多更大样本量的研究进一步证实该结果。
Objective To assess the efficacy and safety of radiofrequency catheter ablation（RA） for the prevention of defibrillator therapy with implantable cardioverter defibrillator（ICD） for patients who have had acute myocardial infarction with ventricular tachycardia（VT）.Methods Randomized controlled trials on patients with VT who underwent RA and ICD versus ICD alone were searched from Pubmed,EMbase,the Cochrane Central register of controlled trials,China Biology Medicine database,Chinese Science and Technology Journal database and the CNKI digital library.Quality assessment and Meta analysis were carried out for the researches sought out from these databases.Results Two randomized controlled studies published on The New England Journal of Medicine and the Lancet were included in our study.RA plus ICD were used in 116 cases,among whom 23 underwent ICD shocks due to reoccurrence of VT or ventricular fibrillation（Vf）.Single ICD was used in 119 cases among whom 49 underwent ICD shocks due to reoccurrence of VT or Vf The result of Meta analysis showed that the number of patients needing ICD shocks after RA plus ICD treatment was significantly lower than that after single ICD treatment.The statistical data of the comprehensive Meta analysis were OR=0.33,95%CI（0.18-0.61）,and P=0.000 4.Conclusion At present,it is believed that RA can be used for the prevention of defibrillator therapy,while the result should be confirmed by large sample research in the future.
出处
《华西医学》
CAS
2011年第4期535-539,共5页
West China Medical Journal
