CAJ | 학술논문

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89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.
목적 분석식입형심률전복제전기(ICD)급심장재동보치료제전기(CRT-D)일급예방환자적실성심률실상발생정황.방법 통계분석2007년1월지2012년6월재절강의원인일급예방이식입ICD혹CRT-D적소유환자.결과 140례환자중,식입ICD적환자51례,CRT-D환자89례,평균수방(26.8±12.6)개월.결과현시재ICD일급예방중계동ICD정학치료적실성심률실상발생솔위19.3％,오치료솔위12.9％,기중오치료중85.3％발생재단강ICD일급예방중.ICD일급예방중주요사망원인위심력쇠갈(52.2％),비심장원인사망(39.1％).ICD정학치료조여미치료조상비,관QRS시한、저좌심실사혈분수(LVEF)급고B형뇌납태(NT-proBNP)용역도치실성심률실상발생.결론 재ICD혹CRT-D일급예방환자중,관QRS시한、저LVEF급고NT-proBNP용역도치실성심률실상발생；ICD오치료주요발생재단강ICD환자.
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 followup of 26.8±12.6 months.Recordings showed that correct treatment of ventricular arrhythmias in ICD primary prevention was 19.3％,misuse treatment rate was12.9％,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 therapyoccurred mainly in patients with single-chamber ICD.