埋藏式心脏复律除颤器植入后的电风暴

Effect of implantable cardioverter defibrillator on the incidence of electrical storm

目的:分析埋藏式心脏复律除颤器/心脏再同步治疗除颤器(ICD/CRT-D)术后患者发生电风暴(ES)的临床特点。方法:回顾性分析245例ICD/CRT-D植入的患者的临床资料,比较发生ES及未发生ES的基础临床特征。结果:CRT-D组33例(27.5%)出现ES,其中16例(48.5%)以室速、10例(30.3%)以室颤为首发心律失常事件。ICD组21例(16.8%)出现ES,其中10例(47.6%)以室速为首发恶性心律失常事件,同CRT-D不同,该组室速、室颤多在术后12个月后出现。左室射血分数(LVEF)减低的患者发生ES的几率更高,为发生ES的独立危险因素(OR 3.26,P<0.001)。结论:ES在ICD/CRT-D术后患者中并不罕见,LVEF减低的患者更易发生ES。

Objective： To analyze the clinical features of electrical storm（ ES） in patients who received implantable cardioverter defibrillator or cardiac resynchronization defibrillator（ ICD / CRT-D）. Methods： A retrospective analysis was conducted to investigate the clinical features of 245 patients with ICD / CRT-D. Results： Of 33 cases of CRT-D（ 27. 5%） experiencing ES,16 cases（ 48. 5%） developed ventricular tachycardia and 10 cases（ 30. 3%） with ventricular fibrillation as the first arrhythmic event. ES occurred in 21 cases of ICD（ 16. 8%）,and ventricular tachycardia was found as initial malignant arrhythmia events in 10 cases（ 47. 6%）. Patients with lower LVEF had higher opportunity to develop ES. Decreased LVEF is an independent risk factor for ES（ OR 3. 26,P〈0. 001）. Conclusion： ES is not rare in patients with ICD / CRT-D,and is most likely to occur in patients with lower LVEF.