埋藏式心脏复律除颤器临床应用分析

９例药物难治性室性心动过速（ＶＴ）病人接受埋藏式心脏复律除颤器（ＩＣＤ）治疗，其中冠心病７例，扩张型心肌病、房间隔缺损修补术后各１例。８例术前有电击复律／除颤史。９例术前、术后均接受胺碘酮治疗，随访９．８±８．０个月，７例经ＩＣＤ储存资料证实共发生ＶＴ６６６次，１００％被ＩＣＤ有效终止，首次治疗程序成功率为９７％。４例ＶＴ经电击复律，２例因窦性心动过速而误放电，６例有疼痛与恐惧感。１例同时埋置了ＩＣＤ与单极电极导线起搏器，随访１６个月未发现任何不良的相互作用。心理障碍是ＩＣＤ治疗值得重视的问题，医生应协助病人尽量缩短心理调整过程，使之尽快对埋置的ＩＣＤ进行适应。

The Follow up of 9 Patients With Implantable Cardioverter Defibrillators

Implantable cardioverter defibrillators (ICD) were implanted in nine patients with drug refractory ventricular tachycardias(VT),seven with coronary heart disease,one with dilated cardiomyopathy,one with post surgical repaired atrial septal defect.Eight patients experienced electrical cardioversion/defibrillations before ICD implantation.All the nine patients took amiodarone before and after ICD implantation.The average duration of follow up was 9.8±8.0 months.The storage data revealed that 666 episodes of VT were detected and one hundred percent of them terminated by ICD in seven patients,the successful rate of the first treatment programs was 97%.Six patients experienced cardioversion after implantation.Four of them for VT and two for false delivery because of sinus tachycardias,all of them sufferred pain and developed sensation of horror to shock.There was a combined use of ICD and unipolar pacemaker in one patient and no poor interaction was found during follow up of sixteen months.The psychological disorder is a valuable problem of ICD treatment and the doctors should help the patients with ICD adapt themself to ICD at the shortest time.