埋藏式心律转复除颤器在43例遗传性心律失常患者中应用的疗效评价  

Efficacy Evaluation of Implantable Cardioverter-Defibrillator in 43 Patients With Inherited Cardiac Arrhythmia

作　　者：陈旭华[1] 华伟[1] 王靖[1] 浦介麟[1] 张澍[1] 

机构地区：[1]中国医学科学院 北京协和医学院 心血管病研究所 阜外心血管病医院 心内科,北京市100037

出　　处：《中国循环杂志》2012年第6期412-414,共3页Chinese Circulation Journal

摘　　要：目的:对因遗传性心律失常植入埋藏式心律转复除颤器(ICD)患者术后情况及ICD治疗效果进行总结。方法:对我院从2004-01至2011-06出院诊断为长QT综合征、Brugada综合征、致心律失常性右心室心肌病及肥厚型心肌病并且植入了ICD的43例患者进行随访,了解患者术后室性心律失常的发作情况以及ICD的治疗效果。结果:43例患者共随访8～84(37.0±20.6)个月,无患者死亡。经ICD共记录到369次室性心动过速(室速)事件及13次心室颤动(室颤)事件,均被ICD成功终止,ICD共启动治疗程序498次。16例(37.2%)患者在随访期内发生室速/室颤事件,被ICD正确识别并接受了恰当的治疗。无患者因室速/室颤事件发生晕厥。对于室速事件,抗心动过速起搏终止的总成功率为53.4%(197/369),首次成功率为20.8%(77/369)。6例(13.9%)患者发生了不恰当识别,1例(2.3%)患者发生了未识别事件。结论:ICD是治疗遗传性心律失常患者室性恶性心律失常的有效措施,合理设置治疗方案及参数可使ICD更充分地发挥预防猝死的作用。Objective ：To evaluate the efficacy of implantable cardioverter-defibrillator（ICD） in patients with inherited cardiac arrhythmia. Methods：We assessed 43 patients diagnosed for long-QT syndrome, Brugada syndrome, arrhythmogenie right ventricular cardiomyopathy and hypertrophic cardiomyopathy. All patients received ICD implantation in our hospital from 2004 to 2011 and they were followed-up for 8 - 84 （ 37.0±20. 6 ） months. Resuhs：No patient died during follow-up time. There 369 episodes of ventricular tachycardia and 13 episodes of ventricular fibrillation were successfully identified and terminated by ICD,it started therapeutic program for 498 times. ICD correctly identified and treated ventricular tachycardia/fibrillation in 16 （37. 2% ）patients, no one had syncope, it successfully terminated ventrieular tachycardia for 53.4% （197/369）and the initial success rate was 20. 8% （77/369）. ICD had inappropriate identified episodes in 6（ 13.9% ） patients and undetected episode in 1 （2. 3% ） patient. Conclusion：ICD could effectively treat malignant arrhythmia, with reasonable strategy and parameter setting, it may play a better role for preventing sudden cardiac death in patients with inherited cardiac arrhythmia.

关 键 词：随访 埋藏式心律转复除颤器 不恰当治疗 心脏性猝死 遗传性心律失常 抗心动过速起搏 

分 类 号：R541[医药卫生—心血管疾病]