埋藏式心脏复律除颤器在治疗恶性室性心律失常中的作用

The Effect of Implantable Cardioverter-Defibrillator on Malignant Ventricular Arrhythmia

评价埋藏式心脏复律除颤器 (ICD)在恶性室性心律失常治疗中所起的作用。 4例因反复发作室性心动过速 心室颤动 (VT VF)住院患者 ,采用ICD和药物治疗 ,并随访 2 1～ 36个月。结果 :4例患者均有室性心律失常再发 ,复发率 10 0 %。在复发心律失常时全部经ICD治疗成功转复窦性心律 ,有效率 10 0 %。对 4例ICD患者随访发现 ,共有 34次持续性VT VF发作 ,相对集中在 8个不同时间段 ,而每个时段都与患者全身状态改变有关。 2例非心律失常源性死亡。结论 :恶性室性心律失常患者有较高的复发率 ,且多数于再次发作时危及生命。服用抗心律失常药能减少VT VF发作 ,但不能完全控制其发作 ,尤其当患者处于各种应激状下时易反复发作。ICD治疗效果肯定 ,对这类高危患者能起到良好的保护作用 。

To assess the antiarrhythmic effect of implantable cardioverterdefibrillator (ICD) on malignant ventricular arrhythmia,4 patients with recurrent ventricular tachycardia (VT) and fibrillation (VT) were admitted to our hospital,for therapy of either ICD and medication.Then they were followed up for 21-36 months.Result:All the 4 patients had history of recurrent ventricular arrhythmia,100 percent recurrent rate.Patients were treated with ICD which terminated malignant arrhythmia and recovered it to sinus rhythm successfully with 100 percent effective rate.The followup data showed that there were 34 episode of continuous VT/VF in 4 patients.There were 8 relative concentration of episodes in time of their regular condition changes.2 patients died of nonarrhythmic agent.Conclusion:Malignant ventricular arrhythmia had higher recurrent rate and was detrimental to life.The antiarrhythmic drugs can reduce episodes of VT/VF but not control absolutely.The arrhythmia was induced easily and frequently under condition of stress.The efficacy of ICD was positive.ICD has good protection on high risk patients and reduce the arrhythmic mortality.Hence,we must pay great attention to treat the heart disease and prevent other diseases after implantation ICD.[Chinese Journal of Cardiac Pacing and Electrophysiology,2000,14(2):87～88] Implantable cardioverterdefibrillator Ventricular arrhythmia,malignant Followup Medical therapy