植入型心律转复除颤器和心脏再同步治疗植入术后再行心脏移植的原因分析

目的 回顾性分析心脏再同步治疗（CRT）和植入心律转复除颤器（ICD）后再进行心脏移植的病例特点和原因.方法 选择12例植入器械治疗后进行心脏移植的患者,对临床表现、器械治疗后随访、心脏移植的原因进行了回顾性分析.结果 6例患者植入了CRT,6例患者植入ICD,平均年龄22～63（43.67±12.05）岁,植入器械治疗至移植手术的平均时间5～48（26.72±14.02）个月.ICD患者术后进行心脏移植的原因与心律失常发作、ICD频繁放电、ICD电池耗竭、心力衰竭加重有关.CRT患者术后进行心脏移植原因与心力衰竭加重有关.结论 对于需要植入ICD或CRT治疗恶性心律失常的患者,应该严格掌握适应证,植入器械治疗后严密随访观察,根据心力衰竭的发展情况决定心脏移植手术时机.

Reasons for heart transplantation after implantable cardioverter defibrillator or cardiac resynchronization therapy

Objective To retrospectively analyze the surgical operation reasons and the clinical features of patients undergoing heart transplantation in our hospital after cardiac resynchronization therapy or implantable cardioverter defibrillation. Methods The data of 12 patients undergoing heart transplantation in our hospital after cardiac resynchronization therapy or implantable cardioverter defibrillation were summarized and analyzed retrospectively. Results The average age of 12 patients was 22 ～ 63 (43.67 ± 12. 05 )years. On average,time from receipt of the device to transplantation was 5 ～48(26. 72 ± 14. 02)months. The reasons for heart transplantation included frequently heart arrhythmia, battery exhausted, and heart failure. Conclusion It is necessary to strictly control the indications for the receipt device for arrhythimia treatment. Follow-up the patients was very important after CRT or ICD. Whether to perform heart transplantation depends on the heart failure level.