6例埋藏式心脏转复除颤器频繁电击分析与处理

目的分析6例埋藏式心脏转复除颤器(ICD)患者术后频繁电击的临床特点。方法回顾2008年至今42例ICD植入患者中6例术后频繁电击的临床资料。结果 6例发生频繁电击(发生率14.3%),随访8~38个月,死亡1例。1例CRT-D患者半年内发生6次ICD电风暴,多为反复发生室性心动过速(VT)、快VT(FVT),抗心动过速起搏(ATP)无效升级为电击治疗或者ATP诱发FVT、心室颤动(VF)而行电击治疗,首次电风暴9个月后死于顽固心力衰竭;1例左上腔植入单腔ICD患者出现3次血流动力学稳定的VT事件频率进入VF诊断区直接电击治疗6次且无效;1例单腔ICD患者因T波过感知致11次误放电;1例双腔ICD患者出现3次血流动力学稳定的VT事件,ATP失败后电击治疗6次且无效,此3例均经优化程控后无电击事件。1例CRT-D患者因右室电极脱位至三尖瓣环处致P、R双计数误识别为3次VF并予电击,经再次手术复位后无类似事件。1例CRT-D患者极短期内因2次VF事件及1次VT事件,10阵ATP无效而先后3次电击治疗,优化药物及程控后无电击事件。结论ICD术后频繁电击病因及诱因治疗是预防发生和及时终止的基础,优化药物及程控治疗可降低对电击治疗的需求及误放电的发生,必要时手术调整或导管消融。     

植入型心律转复除颤器治疗冠心病伴室性心律失常疗效观察

目的 观察冠心病伴恶性室性心律失常患者植入心律转复除颤器(ICD)治疗后的长期预后.方法 23例冠心病患者,其中男性18例,女性15例,年龄(71.56±10.38)岁.心功能不良16例.22例行血运重建术(经皮冠状动脉介入术20例,冠状动脉搭桥术2例).术后发生晕厥9例,持续性室性心动过速(VT)发作22例,心室颤动(VF)发作5例.植入单腔ICD(VVI)15例,双腔ICD(DDDR)1例,三腔ICD(CRT-D)7例.随访时间平均为(33.37±25.39)个月.结果 (1)死亡2例,因急性心肌梗死和急性左心衰竭死亡各1例.(2)4例患者术后再次住院.原因:1例为心功能不良,3例为ICD多次放电住院.(3)13例(56.5%)发生持续性VT或VF事件.持续性VT发作434次,386次(98.6%)经抗心动过速起搏(ATP)治疗成功.FVT发作25次,ATP治疗FVT总的成功率为84.0%.(4)ICD电风暴3例.(5)ICD误识别及误治疗2例.结论 冠心病伴恶性室性心律失常患者血运重建后用ICD治疗,可防止由于心肌的慢性的瘢痕产生室性心律失常而导致猝死的风险.     

ICD不适当识别与治疗的原因与处理

目的分析埋藏式心脏转复除颤器（ICD）不适当识别或治疗事件的原因,为避免不适当识别或治疗事件提供参考。方法回顾2008年至今42例ICD植入患者中发生不适当识别及治疗的临床资料。结果 34例随访18.5±11.7月,9例发生不适当识别或治疗事件,发生率26.5%,其中单腔ICD2台,双腔ICD 1台,CRT-D6台。4例发生不适当识别12次,7例发生不适当治疗29次,其中2例不适当识别及治疗共存。1例发生3次血流动力学稳定的室性心动过速（VT）事件,经抗心动过速起搏（ATP）失败后予电击治疗6次;3例发生快VT（FVT）事件,频率进入心室颤动（VF）区即给予电击共8次;1例右室电极脱位致P/R双计数误识别为VF11次,3次予电击,余充电后放弃;1例T波过感知误电击11次及误识别2次;1例电磁干扰误电击1次;1例干扰误识别为VF1次但充电后放弃;1例窦性心动过速误识别VT1次并予ATP治疗。结论 ICD术后不适当识别或治疗比较常见,规范程控随访,利于及时发现异常调整参数,优化程控治疗,可以减少不适当识别及电击。     

置入埋藏式心律转复除颤器的长期随访

目的报道8例埋藏式心脏转复除颤器（1CO）治疗恶性室性心律失常的疗效及随访结果。方法对置入ICD的8例患者进行电话询问和门诊随访,通过常规心电图、动态心电图及ICD存储的资料,对患者病情和ICDT作情况进行分析。结果8台ICD共检出心律失常事件263次,其中202次为短阵非持续性室性心动过速（VT）,自行终止,61次为持续性VT／（室颤）VF,32次为抗心动过速（ATP）终止,21次为低能量电击终止,8次为高能量电击终止,再发恶性室性心律失常全部经ICD成功转复为窦性心率,有效率100％。误放电治疗8次。误放电原因：阵发性心房颤动心室率超过设置的VT频率,ICD发生误识别。结论ICD治疗恶性室性心律失常效果肯定,但应加强随访,警惕误放电。     

植入带有家庭监测系统的心律转复除颤器20例临床随访及评价

目的 对我院20例植入带有家庭监测系统的心律转复除颤器(ICD)患者进行门诊及家庭监测系统随访.探讨家庭监测系统对植入ICD患者电极导线及脉冲发生器安全性评价及对包括房性心律失常、恶性室性心律失常在内的临床事件的早期发现及干预效果.方法 收集20例2010年6月至2011年11月在我院植入带有家庭监测系统的ICD患者的临床特征、植入信息及通过家庭监测网站系统和门诊常规随访结果,将随访结果进行回顾性总结分析.结果 20例患者随访117 ～ 644(332.90±175.25)d,在随访过程中,累计有6例患者有室性心律失常事件发生,其中有5例患者成功接受ICD,占全部患者的25％.1例患者因快速心房颤动(房颤)被误识别为心室颤动(VF)而进行电除颤.5例成功接受ICD治疗的患者中有1例患者曾因房性心动过速(房速)误识别为室性心动过速(VT)而进行电除颤,误识别及误放电的发生率为9.1％.除去误识别及误放电外,所有患者共发作室上性心动过速(SVT) 238次,VT/VF 20次,其中VT 7次(35％),VF 13次(65％).VT发作均由抗心动过速起搏治疗(ATP)终止,共发放26阵ATP,成功转复7次,ATP转复率27％,VT治疗成功率100％.VF导致充电开始13次,其中10次在ICD结束充电前自行终止,3次在放电治疗后成功转复,ICD治疗成功率100％.20例患者中无1例死亡.结论 通过家庭监测网络系统,不仅可以对ICD患者电极导线及脉冲发生器的正常运转进行有效监控,还可以在患者出现自觉症状前尽早发现患者潜在的恶性心律失常事件和心功能的恶化,并给予及时处理,以避免ICD事件的发生和治疗,从而给患者带来更大的获益.     

植入型心律转复除颤器在长QT综合征患者中的应用

目的 总结阜外心血管病医院应用植入型心律转复除颤器(ICD)治疗长QT综合征(LQTS)患者的经验.方法 8例LQTS患者接受了ICD治疗,平均年龄(38.9±16.7)岁.在随访期间,根据具体情况,调整ICD的各项程控参数.结果 平均随访(27.3±25.9)个月,有3例患者出现了101次室性心动过速/心室颤动(VT/VF)事件.在出厂程控参数下,共记录到44次VF事件.重新设置VT/VF的识别及治疗参数后,共记录到57次VT事件,2次VF事件,大部分自行终止或经低能量转复成功.1例患者术后出现了电风暴,通过快速心室起搏,终止了尖端扭转性室性心动过速(Tdp)的反复发作.2例患者发生了因T波误感知导致的ICD误放电,通过延长感知灵敏度自动调整延迟,从而避免了T波误感知.结论 针对LQTS患者的发病特点,调整ICD的程控参数,可以提高疗效并减少ICD误放电.     

埋藏式心脏转复除颤器放电无效事件原因分析与处理

目的:分析3例埋藏式心脏转复除颤器(implantable cardioverter defibrillator,ICD)患者14次放电无效的临床特点。方法:回顾2008年至今42例ICD置入患者中3例放电无效的临床资料。结果:①38例患者完成规律随访,其中3例出现14次放电无效,男性2例,女性1例,平均年龄38~67岁,长Q-T综合征1例,缺血性心肌病2例,单腔ICD 1台,双腔ICD 1台,CRT-D 1台,均为二级预防,平均随访8~38个月;②ICD正确识别室性心律失常并行放电治疗共55次,低能量转复(CV)治疗38次,成功26次,转复成功率68.4%,高能量除颤(DF)治疗17次,成功15次,除颤成功率88.2%,其中放电无效事件14次,发生率25.5%。③1例CRT-D患者6个月内发生17次放电事件,其中2次快速室性心动过速(FVT)事件予10J转复无效,增加能量后成功转复,经积极综合治疗室性心律失常事件虽明显减少且三磷酸腺苷(ATP)有效,但首次放电9个月后因顽固心力衰竭死亡;1例经左上腔置入单腔ICD患者出现血流动力学稳定的3阵室性心动过速(VT)事件,但频率进入心室颤动(VF)诊断区直接放电6次均无效,经提高VF诊断频率、延长VT识别间期、改变除颤极性及加量应用美托洛尔等处理,随访1年余3次VT/FVT事件经ATP治疗成功;1例双腔ICD患者出现血流动力学稳定的3阵VT事件,抗心动过速起搏(ATP)失败后放电6次均无效,经加强ATP及药物治疗,随访6个月VT事件减少,且ATP治疗有效,未再放电。结论:ICD存在其局限性,原发病的治疗及药物治疗仍然是防治心律失常的基石,放电无效现象是严重并发症,除颤阈值测定对特殊个体可能是必要的,优化程控予以矫正至关重要,必要时仍需手术调整。     

埋藏式心脏转复除颤器参数优化减少不适当电击

目的分析埋藏式心脏转复除颤器(ICD)参数优化在减少ICD不适当电击中的作用。方法 62例植入ICD的患者,男45例,女17例,植入单腔ICD 29例,双腔ICD 13例,三腔ICD 20例,随访20.6±14.6个月。结果 6例出现不适当电击,占9.7%。其中双腔ICD 5例,三腔ICD 1例。出现不适当电击的患者的临床特征与其他患者并无区别。在分析患者发生不适当电击的原因后在抗心律失常药物的基础上调整优化ICD参数,包括:延长快室性心动过速(FVT)或VT2区的识别心搏数目;提高心室颤动区的判定心搏数目和低限频率;调整P-R Logic分区比值;严格室上性心动过速与室性心动过速的鉴别流程。经治疗后6例均未再发生不适当电击。结论根据患者出现不适当电击的临床情况和ICD的内在鉴别流程,个体化ICD参数优化是减少不适当电击的有效手段。     

植入型心律转复除颤器治疗室性快速心律失常的临床应用

目的探讨植入型心律转复除颤器（ICD）对室性快速心律失常的治疗效果以及随访过程中所遇到的问题。方法48例植入ICD患者（其中8例为双腔ICD）,根据患者室性心动过速（VT）/心室颤动（VF）发作时的频率及对血流动力学的影响确定方法和参数,并对植入ICD患者定期随访。结果48例患者顺利植入ICD,无并发症,在随访1～38个月中,患者共发作VT/VF 1 025次（VT764次,占74.5%;VF 261次,占25.5%）,其中1 009次（98.4%）治疗成功,16次在ICD充电结束前自行终止。764次VT中,658次（86.1%）经抗心动过速起搏（ATP）终止,106次（13.9%）经低能量复律（CV）终止。261次VF中,经高能量除颤（DF）均终止。6例患者发生误放电19次,8例双腔ICD患者无误放电。结论ICD的疗效是确定的。但单腔ICD常会发生误识别、误放电,随访和及时调整参数可避免或减少此类情况发生。双腔ICD提高了对室上性心律失常的识别能力,从而减少误发电。同时应合理应用抗心律失常药物,高度重视ICD患者的心理治疗。     

经静脉安置埋藏式心脏复律除颤器的临床应用

对 5例恶性室性心律失常患者安置埋藏式心脏复律除颤器 (ICD)治疗。 5例均为男性 ,年龄 39～ 74岁。冠心病 (1例为前壁心肌梗死 ) 3例 ,心肌病、扩张型心肌病伴左束支阻滞及Ⅰ度房室阻滞各 1例。药物治疗效果不佳。3例冠心病及 1例心肌病患者置入单腔ICD ,扩张型心肌病置入双腔ICD。 5例均成功置入ICD。平均起搏阈值0 .5 2V ,平均R波振幅 15 .7mV。随访 6～ 36个月 ,4例患者出现快频率室性心动过速 (简称室速 ) ,经抗心动过速起搏及低能量电击转复为窦性心律 ,平均电击能量 5 .4J。 1例发生室上性心动过速导致ICD误放电治疗 ,经重新设置室速频率窗口 ,未再出现误放电。结论 :ICD能有效转复恶性室性心律失常 ,双腔ICD因增加了心房电极 ,在改善血液动力学、预防房性及室性快速心律失常、降低不适当ICD治疗等方面优于单腔ICD     

植入型心律转复除颤器不适当识别和治疗的发生率及常见原因

目的 植入型心律转复除颤器（ICD）是恶性室性心律失常患者惟一有效的治疗措施。不适当识别和治疗是ICD最常见的并发症，也是导致ICD患者再住院最主要的原因。本文旨在评价本中心的ICD患者不适当识别和治疗的发生率及常见原因。方法 入选2000年1月至2005年12月在本中心因室性心律失常植入ICD并能定期随访的50例患者。根据患者心律失常特点和心功能情况程控ICD的各项参数，定期随访，询问ICD中所有信息，打印、存盘并对储存的腔内电图进行逐条分析，以确定ICD诊断是否准确以及治疗是否有效，判断有无ICD不适当识别和治疗。结果 38例患者在随访期间发生了心律失常事件，ICD共记录到491次室性心动过速（VT）或心室颤动（VF）事件（VT383次，VF108次），其中有11例（22％）发生过≥1次的不适当识别和治疗事件。14．3％（55／383）的VT事件为不适当识别，并导致了78次抗心动过速起搏（ATP）治疗和9次电击治疗。VF不适当识别的发生率为26．9％（28／108），并导致了56次不适当电击事件。结论 植入新一代ICD患者中，不适当识别和治疗发生率仍较高。不适当识别和治疗最常见的原因是心房颤动（房颤）伴快速心室率，占50％以上；其次是由于电磁干扰或肌电干扰所致。     

Sensing and detection in Medtronic implantable cardioverter defibrillators

Ensuring sensing and detection of ventricular tachycardia (VT) and ventricular fibrillation (VF) was a prerequisite for the clinical trials that established the survival benefit of implantable cardioverter defibrillators (ICDs). However, for decades, a high incidence of unnecessary shocks limited patients’ and physicians’ acceptance of ICD therapy. Oversensing, misclassification of supraventricular tachycardia (SVT) as VT, and self-terminating VT accounted for the vast majority of unnecessary shocks. Medtronic ICDs utilize sensitive baseline settings with minimal blanking periods to ensure accurate sensing of VF, VT, and SVT electrograms. Programmable algorithms reject oversensing caused by far-field R waves, T waves, and non-physiologic signals caused by lead failure. A robust hierarchy of SVT-VT discriminators minimize misclassification of SVT as VT. These features, combined with evidence-based programming, have reduced the 1?year inappropriate shock rate to 1.5?% for dual-/triple-chamber ICDs and to 2.5?% for single-chamber ICDs.     

Supraventricular Arrhythmias in Children and Young Adults with Implantable Cardioverter Defibrillators

INTRODUCTION: Rapidly conducted supraventricular tachycardias (SVTs) can lead to inappropriate device therapy in implantable cardioverter defibrillator (ICD) patients. We sought to determine the incidence of SVTs and the occurrence of inappropriate ICD therapy due to SVT in a pediatric and young adult population. METHODS AND RESULTS: We undertook a retrospective review of clinical course, Holter monitoring, and ICD interrogations of patients receiving ICD follow-up at our institution between March 1992 and December 1999. Of 81 new ICD implantations, 54 eligible patients (median age 16.5 years, range 1 to 48) were identified. Implantation indications included syncope and/or spontaneous/inducible ventricular arrhythmia with congenital heart disease (30), long QT syndrome (9), structurally normal heart (ventricular tachycardia/ventricular fibrillation [VT/VF]) (7), and cardiomyopathies (7). Sixteen patients (30%) received a dual-chamber ICD. SVT was recognized in 16 patients, with 12 of 16 having inducible or spontaneous atrial tachycardias. Eighteen patients (33%) received > or =1 appropriate shock(s) for VT/VF; 8 patients (15%) received inappropriate therapy for SVT. Therapies were altered after an inappropriate shock by increasing the detection time or rate and/or increasing beta-blocker dosage. No single-chamber ICD was initially programmed with detection enhancements, such as sudden onset, rate stability, or QRS discriminators. Only one dual-chamber defibrillator was programmed with an atrial discrimination algorithm. Appropriate ICD therapy was not withheld due to detection parameters or SVT discrimination programming. CONCLUSION: SVT in children and young adults with ICDs is common. Inappropriate shocks due to SVT can be curtailed even without dual-chamber devices or specific SVT discrimination algorithms.     

Inappropriate discharges from an intravenous implantable cardioverter defibrillator due to T-wave oversensing.

This report describes the clinical management of 2 patients with ventricular fibrillation (VF) who received inappropriate shocks from an implantable cardioverter defibrillator (ICD) due to T-wave oversensing. Cardiac sarcoidosis was confirmed as the underlying heart disease in 1 patient and idiopathic dilated cardiomyopathy in the other. Within 2 months after ICD implantation, both patients received several inappropriate shocks during sinus rhythm. Stored electrograms showed decreased R-wave amplitudes and increased T-wave amplitudes. The ICD sensed both R- and T-waves as ventricular activation, which met the rate criteria for VF treatment. Reprogramming the sensing threshold in association with administration of a drug to slow the heart rate decreased the incidence of the inappropriate shocks in both patients, but these palliative measures did not completely suppress the inappropriate shocks. To avoid T-wave oversensing, the repositioning or adding of a sensing lead is required. The potential risk of T-wave oversensing in ICD patients who have small R-wave amplitudes should be recognized.     

Dual Chamber Implantable Cardioverter Defibrillator Benefits and Limitations

Dual chamber ICD capable of providing dual chamber pacing (DDD) and ventricular arrhythmia therapy is now available. We report our experience of clinical performance of dual chamber ICDs amongst Chinese population.Methods: 9 patients (6 men and 3 women) received dual chamber ICDs, mean age 50 ± 18.8 years. The indications were ventricular fibrillation (VF) [5], hemodynamic intolerant ventricular tachycardia (VT) [3] and unexplained syncope plus positive induction of VF [1]. The underlying cardiac pathology were congenital LQT syndrome(1), hypertrophic cardiomyopathy [2], coronary artery disease [2], rheumatic valvular disease [1], Brugada syndrome [1], arrhythmogenic right ventricular dysplasia [1] and idiopathic VF [1]. Four patients have documented paroxysmal atrial fibrillation (AF). All patients have defibrillation thresholds (DFT) determined with a binary search protocol starting at 12 joules (J) at implantation.Results: A total of 34 episodes of VF were induced at implantation with mean DFT 13.8 ± 7 J. The average shocking impedance was 40 ± 3.6 . The mean acute P wave measured 3.3 ± 1.3 mV and R wave measured 13.2 ± 3.2 mV. Atrial and ventricular thresholds, at pulse width 0.5 ms, averaged 0.8 ± 0.4 V and 0.4 ± 0.2 V. During follow-up period, 16 episodes of VF were documented and were successfully treated with the first programmed shock. In the patient with LQT syndrome, DDD was initiated to prevent pause-dependant VF. Three episodes of inappropriate therapy (15.8%) were delivered. One patient experienced 2 shocks after exercise. Stored electrograms showed sinus tachycardia with first degree heart block which was misdiagnosed as VT with retrograde 1:1 conduction. Another inappropriate therapy occurred with AF with fast ventricular response within the VF zone and VT therapy inhibitor was disabled.Conclusion: Dual chamber ICD allows combined benefits of DDD and VT/VF therapy. Storage of both atrial and ventricular electrograms provide more information in elucidation of nature of dysarrhythmias. Inappropriate shocks, though reduced, are still possible and the rigid algorithms of SVT discrimination from VT will need further published.     

植入型心律转复除颤器35例次随访

目的报告35例植入型心律转复除颤器（ICD）的随访结果.方法对我院1998年5月至2004年4月植入的31例,另有4例更换ICD患者进行电话询问和门诊随访（3～70个月,平均36.5个月）,通过常规心电图、动态心电图及ICD存储的资料,对患者病情和ICD工作情况进行分析.结果 4例患者死亡.31例患者共发作持续性室性心动过速/心室颤动（VT/VF）725次（VT534次,占73.7%,VF191次,占26.3%）,其中719次（96.8%）治疗成功,6次（3.2%）失败.534次VT中,454次（85.5%）经抗心动过速起搏（ATP）终止,80次（14.5%）经低能量复律（CV）终止.191次VF中,185次（96.9%）经高能量除颤（DF）终止,1例患者无效放电6次.3例患者发生误放电7次.结论 ICD疗效肯定,须密切随访,及时调整工作参数;应高度重视ICD患者的心理治疗.     

埋藏式心脏转复除颤器的随访

目的报道37例埋藏式心脏转复除颤器(ICD)的随访结果。方法对置入ICD的37例患者进行电话询问和门诊随访,通过常规心电图、动态心电图及ICD存储的资料,对患者病情和ICD工作情况进行分析。结果37例患者共发作室性心动过速/心室颤动(VT/VF)917次(VT745次,VF172次),其中911次(99.3%)治疗成功,6次(0.7%)失败。非持续性VT122次(16.4%),发作均自行停止。623次持续性VT(83.6%)中,537次(86.2%)经抗心动过速起搏(ATP)终止,82次(13.2%)经低能量复律(CV)终止,3次(0.4%)在ATP治疗过程中加速为VF,由高能量除颤(DF)终止。172次VF中,167次(97.1%)经DF终止,1例无效放电5次(2.9%)系因电池提前耗竭而更换了ICD脉冲发生器,2例共8次阵发性心房颤动心室率超过设置的VT频率ICD发生误识别,给予ATP治疗。5例术后1~6个月出现心律失常“电风暴”。5例对电击恐惧造成了不同程度的心理障碍,经教导必要时辅以药物治疗后症状得以缓解。共有19例术后因VT发作频繁而服用胺碘酮/美托洛尔,并根据心律失常发作情况调整用药剂量。结论ICD置入后应加强随访,及时调整工作参数,同时辅助药物、改善心功能和心理治疗。     

Ablation of atrial fibrillation in Brugada syndrome patients with an implantable cardioverter defibrillator to prevent inappropriate shocks resulting from rapid atrial fibrillation

Background

Inappropriate shocks resulting from atrial tachyarrhythmias are highly problematic for patients with an implantable cardioverter defibrillator (ICD). We aimed to determine the effectiveness of catheter ablation of atrial fibrillation (AF) in preventing inappropriate shocks due to rapid AF in patients diagnosed with Brugada syndrome (BS) who were implanted with an ICD.

Methods

We performed AF ablation in 5 BS patients with ICDs who experienced inappropriate shocks caused by rapid paroxysmal AF and in a BS patient scheduled to determine an indication of an ICD implantation who frequently experienced rapid AF.

Results

Although 2 patients underwent a 2nd ablation procedure because of AF recurrences, 5 of the 6 patients were finally free from AF after their last procedure during a median follow-up period of 43.2 months. No further inappropriate shocks caused by rapid AF occurred after the 1st ablation session in any of the patients. A patient developed a ventricular fibrillation storm during his electrophysiological study following the ablation procedure, and then was implanted with an ICD.

Conclusions

AF ablation in BS patients may be reasonable to prevent inappropriate ICD shocks resulting from rapid AF. However, ventricular extrastimuli just after the ablation had better be avoided in them.     

埋藏式心脏转复除颤器误治疗原因分析

目的分析埋藏式心脏转复除颤器(ICD)误治疗的主要原因并探讨应对策略。方法对30例符合纳入标准的ICD植入病人进行随访分析,其中心脏性猝死一级预防23例,二级预防7例;单腔ICD17台,双腔ICD13台(包括CRT-D4台)。术后3个月进行常规随访,以后每6个月随访1次。随访期间如果病人自觉ICD放电或其它相关症状尽早至医院随访。由2位有经验的电生理专业医生根据ICD治疗事件心内电图对ICD治疗方式进行分类,如果治疗不是针对室性心动过速(VT)或心室颤动(VF)则该治疗定义为误治疗。结果78例次随访中,45次ICD治疗事件包括36次抗心动过速治疗(ATP)和9次放电,其中误治疗33次(73%),包括27次ATP治疗和6次放电。33次误治疗共涉及5例病人(17%),均为单腔ICD。误治疗的原因均为室上性快速性心律失常(SVT-A)。结论误治疗是比较常见的ICD相关事件。植入ICD后应尽早打开SVT-A相关的诊断功能。