三种类型的埋藏式心脏转复除颤器识别功能的比较

Comparative study of A+-ICD, single- chamber ICD and dual-chamber ICD in recognition

目的观察三种类型埋藏式心脏转复除颤器(ICD)(A+-ICD、单腔ICD和双腔ICD)识别室性心律失常事件的准确性。方法回顾性分析植入ICD的患者113例,根据ICD型号不同分为A+-ICD组(n=39),单腔ICD组(n=38),双腔ICD组(n=36)。通过ICD程控随访收集患者心律失常事件。结果 1年随访时间内A+-ICD组有14例、双腔ICD组有8例发作阵发性心房颤动。A+-ICD组26例共记录1147次快速型心律失常事件,207次(100%)被正确识别为室性心动过速(简称室速)或心室颤动(简称室颤),938次(99.8%)被正确识别为室上性心动过速(简称室上速);单腔ICD组13例共记录318次快速型心律失常事件,172次(83.9%)被正确识别为室速或室颤,106次(93.8%)被正确识别为室上速;双腔ICD组13例共记录304次快速型心律失常事件,240次(100%)被正确识别为室速或室颤,64次(100%)被正确识别为室上速。结论 ICD的心房腔内电图有助于鉴别心律失常事件,监测心房颤动的发生;A+-ICD性能上优于传统单腔ICD。

Objective By taking observations on three types of implantable cardioverter defibrillator(ICD), which are A+-ICD,single-chamber ICD and dual-chamber ICD, to discriminate the accuracy of arrhythmia episodes. Methods Retrospective analysis was done on 113 patients with ICD implanted, whom were divided into three groups according to different ICD types, [A+-ICD(n=39), single-chamber ICD(n=38), dual-chamber ICD(n=36)]. Arrhythmia episodes were collected by ICD program during the follow-up. Results Fourteen patients with paroxysmal atrial fibrillation in group A+-ICD, and eight with arrhythmia in group dual-chamber ICD was detected in one-year follow-up.In group A+-ICD, 26 patients with 1 147 times tachyarrhythmia episodes were recorded, of which 207 times(100%) were correctly classified as ventricular tachycardia(VT) or ventricular fibrillation(VF), and 938 times(99.8%) as supraventricular tachycardia(SVT).In group single-chamber ICD, 13 patients with 318 times tachyarrhythmia episodes were recorded, of which 172 times(83.9%) were correctly classified as VT or VF, and 106 times(93.8%) as SVT.In group dual-chamber ICD, 13 patients with 304 times tachyarrhythmia episodes were recorded, of which 240 times(100%) were correctly classified as VT or VF, and 64 times(100%) as SVT. Conclusions Atrial electrograms of ICD helps to discriminate arrhythmia episodes and monitor atrial fibrillation.A+-ICD is superior to the traditional single chamber ICD in performance.[Chinese Journal of Cardiac Pacing and Electrophysiology,2021,35(3):211-213]