CAJ | 학술논문

目的评价植入型心律转复除颤器(ICD)在慢性心力衰竭患者心脏性猝死一级预防中的治疗作用.方法对2005年1月至2008年12月符合ICD一级预防标准并植入ICD的患者进行随访.ICD的诊断设置室性心动过速(VT)、心室颤动(VF)两个工作区,治疗设置抗心动过速起搏(ATP)、低能量同步转复(CV)和高能量除颤(DF).术后患者常规给予抗心律失常药物.每3～6个月随访1次,利用程控仪获取ICD储存资料,了解患者心律失常发作情况以及ICD的诊断和治疗是否准确,及时调整相关参数并处理ICD故障.结果共随访了22例患者,平均随访(12.8±8.6)个月.共有lO例患者记录到ICD治疗事件.10例患者ICD记录到持续性VT事件,其中由ATP终止6例,CV终止4例.4例患者有VF事件,均1次DF成功.2例ICD将快速心室率心房颤动(AF)识别为VF并进行放电治疗并转复房颤.结论 ICD在慢性心力衰竭患者心脏性猝死一级预防中的治疗效果是肯定的,ICD联合抗心律失常药物能有效治疗恶性室性心律失常,预防心脏性猝死.
목적 평개식입형심률전복제전기(ICD)재만성심력쇠갈환자심장성졸사일급예방중적치료작용.방법 대2005년1월지2008년12월부합ICD일급예방표준병식입ICD적환자진행수방.ICD적진단설치실성심동과속(VT)、심실전동(VF)량개공작구,치료설치항심동과속기박(ATP)、저능량동보전복(CV)화고능량제전(DF).술후환자상규급여항심률실상약물.매3～6개월수방1차,이용정공의획취ICD저존자료,료해환자심률실상발작정황이급ICD적진단화치료시부준학,급시조정상관삼수병처리ICD고장.결과 공수방료22례환자,평균수방(12.8±8.6)개월.공유lO례환자기록도ICD치료사건.10례환자ICD기록도지속성VT사건,기중유ATP종지6례,CV종지4례.4례환자유VF사건,균1차DF성공.2례ICD장쾌속심실솔심방전동(AF)식별위VF병진행방전치료병전복방전.결론 ICD재만성심력쇠갈환자심장성졸사일급예방중적치료효과시긍정적,ICD연합항심률실상약물능유효치료악성실성심률실상,예방심장성졸사.
Objective,To assess the eficacy of implantable cardioveter defibrillator(ICD)for primary prevention of sudden cardiac death in patients with heart failure.Methods Patients accepted ICD implantation for primary prevention were enrolled from January 2005 until December 2008.All ICD interventions were classified ag ventricular tachycardia(VT),ventricular fibrillation(VF).Anti-tachycardia parameters were standardized.ATP and shock therapy were provided for VT and VF zone.Antiarrhythmic drug was prescribed after ICD implantation.Follow-up Was performed every 3～6 months after implantation and stored arrhythmic episedes and anti-tachycardia therapies documentation was used to clarify the character of treated tachyeardia.Resuits A total of 22 patients were follow-up for(12.8±8.6)months.The incidences of VT and VF were documented in 10 patients and received appropriate defibrillator therapies.Conclusion ICD therapy has efficacy in prevention for sudden cardiac death in patients with heart failure.