植入型心律转复除颤器的临床应用及随访观察  

Clinical Application of Transvanous Implantable Cardioverter Defibillator

作　　者：吴清华[1] 程晓曙[1] 吴延庆[1] 李菊香[1] 程应樟[1] 程开诚[1] 胡建新[1] 姜醒华[1] 罗伟[1] 

机构地区：[1]江西医学院第二附属医院心内科,江西南昌330006

出　　处：《实用临床医学（江西）》2005年第1期1-3,共3页Practical Clinical Medicine

摘　　要：目的 :观察我院 8例次植入型心律转复除颤器 (implantablecardioveterdefibrillatorICD)患者的临床疗效及随访情况。方法 :自 1996年 7月至 2 0 0 3年 9月 ,共有 7例患者 (其中 1例更换 1次 )在我院成功安装了ICD。 4例为扩张型心肌病 ,1例为长QT间期综合症 ,1例为多形性室性心动过速 ;另 1例为完全性右束支传导阻滞伴恶性室性心律失常 ,Brugada综合症不能排外。所有病人均记录到室性心动过速 (室速 ,VT)或 /和室性纤维颤动 (室颤 ,VF) ,其中 5例病人有晕厥史。平均随访 2 .3年。结果 :7例患者均成功经静脉安置或更换ICD。除颤阈值均在 2 5J以下。随访期间共发生室性快速心律失常 16次 (VT 10次 ,VF 6次 ) ,均成功中止 ,其中抗心动过速起搏 (ATP)终止 10次 ,除颤 6次 (误感知窦性心动过速发生ATP 4次 ,误感知室上性心动过速发生除颤 2次 )。本组 7例中 ,1例扩张型心肌病患者死于心力衰竭 ,其余均正常生活至今。结论 :ICD治疗效果肯定 ,但需加强随访 ,及时调整参数 ,同时需注意药物的辅助治疗。Objective:To observe the clinical effect of ICD(implantable cardioverter-defibrillator, ICD) in seven patients.Methods: The data of seven patients who had successful implantation ICD in the hospital from July 1996 to September 2003 were reviewed retrospectively.In these patients, four were dilated cardiomyopathy; one was long QT syndrome; one was pleomorphism ventriculary tachycardia;one was right bundly branch block accompany serious ventricular arrhythmia(may be Brugada syndrome).All episodes of VT and/or VF had been recorded, five patients had history of syncope.All patients were followed-up for an average of 2.3 years.Results: All patients had sucessful implantation ICD system in Cath Lab.The Defibrillation threshold was less than 25 J.In follow-up,there were sixteen episodes of ventriculary tachyarrhythmia(ten episodes of VT; six episodes of VF) and ten episods of VT which were terminated by antitachycardia pacing (ATP) and had six episodes of VF which were terminated by difibrillation.There were four anti-tachyarrhythmia pacing for mistaken sensed sinus tachycardia and two defibrillation for mistaken sensed supraventricular.All patients survived.Conclusion: Implantation of ICD is an safe effective approach to treat ventricular arrhythmias in patients with structural heart diseases, but we should adjust parameter in time and strengthen follow-up and give drug as assist therapy.

关 键 词：室性心动过速 心室颤动 植入型心律转复除颤器 

分 类 号：R541[医药卫生—心血管疾病]