植入型心律转复除颤器的临床应用及随访

目的报道埋藏式心脏转复除颤器(ICD)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5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5台ICD共检出心律失常事件238次,其中183次为短阵非持续性室性心动过速(VT),自行终止;55次为持续性室性心动过速/心室颤动(VT/VF),29次经抗心动过速(ATP)终止,18次经低能量电击终止,8次经高能量电击终止,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,经调整识别频率后,未再发生。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。

Clinical application and follow up of implantable cardioverter defibrillator

Objective Report the therapeutic effect and follow up results of implantable eardioverter defibrillator （ICD） in treating malignant ventrieular arrhvthmia. Methods Telephone inquiry and outpatient department follow up of 5 patients with ICD implanted were performed. The data stored in ICD and body surface electrocardiogram, as well as ambulatory eleelrocardiogram monitoring were analyzed. Results Totally 238 times arrhythmia episodes were detected in 5 eases. 183 of them were nonsustained VT which spontaneously terminated. 55 of them were VT/VF episodes,which treated by ICD successfully in 29 times,18 limes were terminated by low energy cardioversion and 8 times were terminated by high energy shocks. The totally efficiency rate was 100%. There was 8 limes inappropriate shock delivery occurred because of ventricular rate in paroxysmal arterial fibrillation over than the threshold. Conclusion It validated the positive effect of ICD in treating malignant ventricular arrhythmia, It suggested that the doctors should enhance follow up and vigilance inappropriate shock delivery.