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目的 初步探讨符合埋藏式心脏转复除颤器一级和/或二级预防的患者全皮下ICD(SGICD)筛选通过率及其影响因素.方法 收集符合ICD植入的一级和/或二级预防,无心动过缓起搏依赖病人51例的临床资料,采集卧位和坐位体表心电图(TMSGECG)来模拟SGICD的感知向量,两个体位至少一个向量同时满足SGICD筛选模板方认为筛选通过.结果 51例患者中有45.1%的患者经静脉植入ICD,一共有36例(70.6%)病人通过筛查,筛选通过组Ⅰ(可选向量)、Ⅲ导联(主要向量)通过率均为66.7%,Ⅱ导联(次要向量)通过率最高,为86.1%;3个导联均通过者约38.9%,2个导联通过者约47.2%,1个导联通过者最少,约13.9%.SGICD筛选失败组(n=15)在12导联体表心电图QRS宽度、完全性左束支传导阻滞比例、Rmax、R/Tmax与筛选通过组之间有明显差异(P均<0.05).结论 符合ICD植入指征的患者实际植入ICD的比例较低,约45.1%.70.6%的病人通过SGICD筛查模板,其中Ⅱ导联通过率最高,两个导联同时通过者比例高于1个和3个导联通过者.基线体表心电图QRS增宽、合并完全性左束支传导阻滞、Rmax较低以及R/Tmax比值较小者筛选失败的可能性更大.
Objective To investigate the prevalence of SGICD screening and its influencing factors in patients with primary and / or secondary prevention of implantable cardioverter defibrillators.Methods The primary and / or secondary ICD patients Prevention, no bradycardia pacing dependent on the clinical data of 51 patients, the collection of supine and sitting surface electrocardiogram (TMSGECG) to simulate the perception vector of SGICD, two at least one vector at the same time meet the SGICD screening template that screening through. Results 45.1% of the 51 patients were intravenously implanted into the ICD. A total of 36 patients (70.6%) were screened. The passing rates of group Ⅰ (optional vector) and Ⅲ (major vector) were all 66.7%, Ⅱ lead (secondary vector) the highest pass rate was 86.1%; 3 leads were about 38.9%, about 47.2% of the two lead through, a lead through the least, about 13.9 % .SGICD screening failure group (n = 15) in the 12 lead body surface ECG QRS width, complete left bundle branch block ratio, Rmax, R / Tmax and screening through the group were significantly different (P <0.05 ) .Conclusion The proportion of ICD implanted in the ICD patients is lower than that of ICD implants, accounting for 45.1% .70.6% of the patients passed the SGICD screen Template, of which the highest lead Ⅱ lead, the two leads at the same time by more than 1 and 3 leads through the baseline surface ECG QRS widened, with complete left bundle branch block, Rmax Low and the R / Tmax ratio screening is more likely to fail.