摘要
背景:在危及生命的室性心动过速(VT)存活者中,VT发作前的慢性心力衰竭病史(HxCHF)能相对于已测得的左心室射血分数(LVEF)提供不同的预后信息。方法:作者评估了AVID研究中患者的预后。
Background: In survivors of life-threatening ventricular tachycardia(VT), a history of CHF(HxCHF) before the VT episode may provide different prognostic information than their measured left ventricular ejection fraction(LVEF). Methods: We evaluated outcomes from patients in the AVID study. Patients were included in the study if they presented with ventricular fibrillation, VT with syncope or VT with hemodynamic compromise, and LVEF ≤40%. Treatment options included implantable cardioverter defibrillator(ICD) or antiarrhythmic drugs(AAD), usually amiodarone. Results: As expected, a HxCHF is associated with an increased and high risk of arrhythmic and nonarrhythmic death. However, an interaction was observed between arrhythmia treatment(ICD or AAD)and HxCHF status: the survival advantage with an ICD, as compared with AAD therapy, is largely restricted to HxCHF patients. Conclusions: The ICD is no better than AAD therapy in preventing arrhythmic death in patients with no HxCHF. In this data set, a HxCHF is somewhat more accurate in predicting prognosis and the response to therapy than a reduced LVEF.
