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.

Clinical follow-up of 35 patients with implantable cardioverter defibrillator

Objective To report the follow-up results of 35 patients with implantable cardioverter defibrillator(ICD).Methods Telephone inquiry and out-patient department follow-up of patients with ICD implanted were performed from May 1998 to April 2004,the data stored in ICD and body surface electrocardiogram as well as ambulatory electrocardiogram monitoring were analyzed.Results All patients(18 men,13 women)had received ICD therapy during the average follow-up period of 36.5 months.The cumulative data stored in ICD showed that there were total 725 episodes of ventricular tachycardia/ventricular fibrillation(VT/VF)detected by the devices,534 of them were VT,454 were terminated by ATP,and 80 were terminated by low energy cardioversion;191 of them were VF,185 terminated by shocks,and 6 episodes did not terminated due to incessant VT in one patient.Four patients died.Two out of 4 died of heart failure and no arrhythmic reason during the follow-up period found.One patient suicided because of worrying about high costs.One patient died of VF by electrical exhaustion of ICD and stopping amiodarone himself.Seven times inappreciate shock occurred in 3 patients due to sinus tachycardia.Conclusions ICD with tiered therapy function has high efficacy on termination of ventricular tachyarrhythmias.It is important to follow up the patients and dynamicly optimize the system of ICD.