埋藏式心脏转复除颤器安置后电风暴的处理与预后

目的通过分析埋藏式心脏转复除颤器(ICD)患者的长期随访资料,总结电风暴(ES)的诱发因素、临床处理及预后。方法48例患者共植入50台ICD,ES定义为24hICD正确检测到≥3次室性快速性心律失常,并促发ICD电治疗。结果随访时间中位数为16.9个月。共6例发生了8次ES。常见诱因为严重感染、心力衰竭和肾功能衰竭等。通过纠正诱因,使用抗心律失常药物,能有效减少和避免ICD电治疗。ES发生后,死亡率明显增高。结论ICD患者发生ES有比较明确的诱发因素,并且ES具有一定的预后判断价值。

Management and prognosis of implantable cardioverter defibrillator with electrical storm.

Objective The causes,management and pronosis of electrical storm(ES) were evaluated by analyzing data of patients with implantable cardioverter defibrillators(ICD).Methods Fifty ICDs were implanted in forty-eight patients.The definition of ES was that the ICDs correctly detected three times or more ventricular tachyarrhythmia,and triggered electrical therapy.Results The median follow-up period was 16.9 months,and 2 patients were loss.8 cases of ES were observed in 6 patients.The common causes of ES were severe infection,heart failure,and renal function insufficient.The management of ES included the treatment of the causes and anti-arrhythmia drugs.The mortality was increased in patients with ES.Conclusion In patients with ICD,ES has definite causes and a certain value in prognosis analysis.