埋藏式心脏转复除颤器治疗患者的心房颤动回顾性分析

回顾性分析埋藏式心脏转复除颤器(ICD)治疗患者中心房颤动(AF)的发生率,评价AF对ICD治疗患者再次住院、不适当放电治疗和总死亡率的影响。182例ICD置入患者,随访48±17个月,用存活率回归分析等相关统计方法,对AF组和窦律(SR)组再住院率、不适当放电治疗和总死亡率等进行比较。结果:两组在室性心律失常再发生率和再住院率上无明显差异(P>0.05)。存活率分析,AF组患者较SR组患者低(P=0.038)。ICD治疗患者,新的AF发生率为8.43%。在AF组中,ICD治疗前有AF病史的患者其不适当放电治疗发生率为25%,而新出现AF病史的患者,不适当放电治疗发生率为64.3%(P<0.05)。结论:ICD治疗后,新发现的AF患者有更高的不适当放电治疗危险。有AF病史的患者,3年存活率比一直为窦性节律的患者低。

Retrospective Analysis on the Impact of Atrial Fibrillation in Patients With Implantable Cardioverter-Defibrillators

Arrhythmia Unit, Ramóny Cajal Hospital, Alcala University, Madrid, Spain Retrospective analysis on the incidence of atrial fibrillation (AF) in patients with implantable cardioverter-defibrillators (ICD) was performed to evaluate the effect of AF on rehospitalization, inappropriate therapy and total mortality rate. 182 patients with ICD therapy were studied during a mean follow-up of 48±17 months. The rehospitalization, inappropriate therapy and total mortality rate were compared in patients with AF with those who remained in sinus rhythm. Results:There was no statistically significant difference in ventricular arrhythmia recurrence or rehospitalization rate between two groups(P>0.05). Actuarial survival after follow-up was significantly lower in patients with AF than those without AF(P=0.038) .New AF developed in 8.43% of the patients during the follow-up.In chronic AF, inappropriate therapy in ICDs patients due to AF was 25%, while in new AF, it was 64.3% (P<0.05). Conclusion:It is a risk of inappropriate therapy in new AF patients than those who have AF prior to ICD implantation, actuarial survival in 3 years period is significantly lower in patients with AF than that in those without AF.