植入型心律转复除颤器非适当放电治疗的分析

目的观察植入型心律转复除颤器（ICD）工作情况，通过寻找非适当放电治疗的原因以减少非适当治疗的发生。方法对19例ICD患者随访观察3～57个月，通过ICD储存体心电信号分析．结合病史，确定非适当放电治疗。非适当放电治疗指对窦性心动过速、室上性心动过速、心房颤动、心房扑动、非持续性室性心动过速的ICD放电治疗。结果19例中无ICD放电治疗的患者10例（52．63％），适当放电治疗6例（31．58％），非适当放电治疗3例（15．79％）。总计放电治疗11次（9例），其中非适当放电治疗4次（36．36％）。结论非适当放电治疗的原因复杂多样，其中心房颤动、室上性心动过速是常见原因，调整合适的识别工作模式增强ICD识别功能可以降低非适当放电治疗发生率。

Analysis of Inappropriate Shock in Patients with Implantable Cardioverter Defibrillator

Object To identify causes of inappropriate shocks and reduce inappropriate therapy in patients with implantable cardioverter defibrillator （ICD）. Methods 19 ICD patients were followed up for 3 to 57 months. Inappropriate shocks were determined by analyzing ICD-stored electrogram combined with clinical history. An inappropriate shock was defined as a device discharge for sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, or nonsustained ventricular tachycaidia. Results There was no ICD shock in 10 patients （52.63%）. Appropriate shocks occurred in 6 patients （31.58%） and inappropriate shocks in 3 patients （15.79%）. Of 11 shocks, 4 were inappropriate therapy. Conclusion Atrial fibrillation and sinus tachycardia are main causes of inappropriate shocks. Optimizing ICD algorithms for detection and discrimination may reduce inappropriate shocks.