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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 efficacy and follow-up of 8 patients with implantable cardioverter defibrillator (ICD) in our hospital. METHODS: From July 1996 to September 2003, a total of seven patients (one of whom was replaced by one) had ICDs successfully installed in our hospital. 4 cases of dilated cardiomyopathy, 1 case of long QT syndrome, 1 case of pleomorphic ventricular tachycardia; the other 1 case of complete right bundle branch block with malignant ventricular arrhythmia, Brugada Syndrome can not be exclusive. Ventricular tachycardia (ventricular tachycardia, VT) and / or ventricular fibrillation (VF) were recorded in all patients, and 5 of the patients had a history of syncope. The average follow-up of 2.3 years. Results: All 7 patients were successfully placed or replaced by intravenous ICD. Defibrillation thresholds are below 25J. Ventricular tachyarrhythmia occurred 16 times (VT 10 times, VF 6 times) during the follow-up period, all of which were successfully stopped. Among them, anti-tachycardia pacing (ATP) was terminated 10 times, defibrillation was 6 times Speed ATP 4 times, mistakenly perceived supraventricular tachycardia occurred defibrillation 2 times). In this group of 7 cases, 1 dilated cardiomyopathy patients died of heart failure, the rest are normal life so far. Conclusion: ICD treatment effect is positive, but need to strengthen follow-up, adjust the parameters in a timely manner, with attention to drug adjuvant therapy.