植入型心律转复除颤器对心脏性猝死一级预防临床研究  

ICD for primary prevention of sudden cardiac death

作　　者：卢孔杰 孙国建[2] 陈建明[2] 何浪[2] 袁高辉 韦凡平 程震锋 

机构地区：[1]浙江省湖州中心医院心内科,313000 [2]浙江省浙江医院心内科

出　　处：《中华心律失常学杂志》2013年第2期134-137,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的分析植入型心律转复除颤器（ICD）及心脏再同步治疗除颤器（CRT—D）一级预防患者的室性心律失常发生情况。方法统计分析2007年1月至2012年6月在浙江医院因一级预防而植入ICD或CRT—D的所有患者。结果140例患者中，植入ICD的患者51例，CRT—D患者鼹，例，平均随访（26．8±12．6）个月。结果显示在ICD一级预防中启动ICD正确治疗的室性心律失常发生率为19．3％，误治疗率为12．9％，其中误治疗中85．3％发生在单腔ICD一级预防中。ICD一级预防中主要死亡原因为心力衰竭（52．2％），非心脏原因死亡（39．1％）。ICD正确治疗组与未治疗组相比，宽QRS时限、低左心室射血分数（LVEF）及高B型脑钠肽（NT—proBNP）容易导致室性心律失常发生。结论在ICD或CRT—D一级预防患者中，宽QRS时限、低LVEF及高NT—proBNP容易导致室性心律失常发生；ICD误治疗主要发生在单腔ICD患者。Objective To evaluate the effect of implantable cardioverter defibrillator（ ICD） and Cardiac resynchronization therapy with defibrillator （CRT-D）for primary prevention in patients with ventricular arrhythmia. Method Statistical analysis was performedincollected data fromall patients from 2007 to 2012 in Zhejiang Hospital implanted for primary prevention ICD or CRT-D. Results A total of 140 patients implanted ICD or CRT-Dwereenrolled in this study,51 patients with ICD,89patients with CRT-D,with an average follow- up of 26. 8±12. 6 months. Recordings showed that correct treatment of ventricular arrhythmias in ICD primary prevention was 19.3 %, misuse treatment rate wasl2. 9%, which mistakenly treatment was85.3 %. The leading cause of death in the ICD for primary prevention washeart failure deaths （ 52.2% ） and non-cardiac causes of death（39.1% ）. Theindicators ofventricular arrhythmiasincluded a wide QRS duration ,low LVEF and high NT- proBNP. ConclusionsIn patients with primary prevention ICD or CRT-D, wider QRS duration, lower LVEF and higher NT-proBNPwere the risk factors of ventricular arrhythmias ; ICD Inappropriate therapyoeeurred mainly in patients with single-chamber ICD.

关 键 词：植入型心律转复除颤器 心脏再同步治疗除颤器 心脏性猝死 一级预防 

分 类 号：R541[医药卫生—心血管疾病]