植入型心律转复除颤器对慢性心力衰竭心脏性猝死的一级预防

目的评价植入型心律转复除颤器（ICD）在慢性心力衰竭患者心脏性猝死一级预防中的治疗作用。方法对2005年1月至2008年12月符合ICD一级预防标准并植入ICD的患者进行随访。ICD的诊断设置室性心动过速（VT）、心室颤动（VF）两个工作区，治疗设置抗-tk,动过速起搏（ATP）、低能量同步转复（CV）和高能量除颤（DF）。术后患者常规给予抗心律失常药物。每3～6个月随访1次，利用程控仪获取ICD储存资料，了解患者心律失常发作情况以及ICD的诊断和治疗是否准确，及时调整相关参数并处理ICD故障。结果共随访了22例患者，平均随访（12．8±8．6）个月。共有10例患者记录到ICD治疗事件。10例患者ICD记录到持续性VT事件，其中由ATP终止6例，CV终止4例。4例患者有VF事件，均1次DF成功。2例ICD将快速心室率心房颤动（AF）识别为VF并进行放电治疗并转复房颤。结论ICD在慢性心力衰竭患者心脏性猝死一级预防中的治疗效果是肯定的，ICD联合抗心律失常药物能有效治疗恶性室性心律失常，预防心脏性猝死。

Defibrillator implantation for the primary prevention of sudden cardiac death in patients with chronic heart failure

Objective,To assess the eficacy of implantable cardioveter defibrillator(ICD)for primary prevention of sudden cardiac death in patients with heart failure.Methods Patients accepted ICD implantation for primary prevention were enrolled from January 2005 until December 2008.All ICD interventions were classified ag ventricular tachycardia(VT),ventricular fibrillation(VF).Anti-tachycardia parameters were standardized.ATP and shock therapy were provided for VT and VF zone.Antiarrhythmic drug was prescribed after ICD implantation.Follow-up Was performed every 3～6 months after implantation and stored arrhythmic episedes and anti-tachycardia therapies documentation was used to clarify the character of treated tachyeardia.Resuits A total of 22 patients were follow-up for(12.8±8.6)months.The incidences of VT and VF were documented in 10 patients and received appropriate defibrillator therapies.Conclusion ICD therapy has efficacy in prevention for sudden cardiac death in patients with heart failure.