植入心律转复除颤系统患者的死亡原因分析  

Analysis of death causes in patients with implantable cardioverter defibrillator system

作　　者：孙国建[1] 吴巧元[1] 何浪[1] 刘元伟[1] 沈法荣[1] 

机构地区：[1]浙江医院心内科,310013

出　　处：《中华心律失常学杂志》2013年第1期18-21,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的分析植人型心律转复除颤器（ICD）及心脏再同步除颤器（CRT·D）患者的死亡原因。方法将2001年1月至2011年12月在浙江医院植入ICD及CRT-D的所有患者分为3组：ICD一级预防组，ICD二级预防组及CRT—D组。分析在随访过程中所有死亡患者的死亡原因。主要死亡原因设置为：心力衰竭死亡、其他心脏原因死亡、非心脏原因死亡、猝死及不知原因死亡。结果共有289例患者植入ICD或CRT—D，ICD一级预防51例，二级预防107例，CRT—D131例。平均随访（4．6±2．5）年，死亡54例，其中ICD一级预防有5例（9．8％）患者死亡，ICD二级预防20例（18．7％）患者死亡，CRT．D组29例（22．1％）患者死亡。10年累计所有原因病死率为18．7％。心力衰竭性死亡25例（46．3％），非心脏原因死亡19例（35．2％），有3例（5．6％）患者猝死。结论在植入ICD或CRT—D的所有患者中，心力衰竭死亡及非心脏原因死亡是最常见的死亡原因。猝死在死亡患者中的比例较低。Objective To analyse the causes of death in patients with implantable cardioverter- defibrillator（ ICD ）and cardiac resynchronization therapy defibrillator （CRT-D）. Methods From Jan. 2001 to Dec. 2011 all patients with ICD and CRT-D in Zhejiang hospital were included. All patients were divided into three groups： primary prevention ICD group, secondary prevention ICD group, and CRT-D group. Patients who died during follow-up period were retrieved. The causes of death included heart failure, other cardiac death, non-cardiac death, sudden death, and unknown cause of death. Results A total of 289 patients were included： 51 primary prevention ICD, 107 secondary prevention ICD, and 131CRT- D. Average follow-up period was（4.6＋2.5 ）years. Five patients （9.8%） with primary prevention ICD,20 patients（ 18.7% ） with secondary prevention ICD, and 29 patients（22.1% ） with CRT-D died. The lO-year cumulative incidence of all-cause mortality was 18.7%. There were 25 （46.3%） patients died from heart failure, 19 （ 35.2 % ） non-cardiac reason, and 3 （ 5.6 % ） patients were sudden death. Conclusion Heart failure and non-cadiac death were the most common causes of death; incidence of sudden death was low.

关 键 词：植入型心律转复除颤器 心脏再同步治疗除颤器 病死率 死亡原因 

分 类 号：R541.7[医药卫生—心血管疾病]