CAJ | 학술논문

目的：本文旨在观察植入型心律转复除颤器( ICD)植入后电风暴( ES)的发生率和临床特征。方法回顾性分析2003年1月至2010年10月在阜外医院植入ICD的134例患者术后的临床治疗和ICD程控资料,比较发生ES和未发生ES的患者基础心脏病、心功能、药物治疗和预后的差异。结果17．4%的ICD患者发生过ES事件,其中70%患者事件数≥2,89．5%的ES是由于室性心动过速( VT)引起的。与未发生ES的患者相比,发生ES患者的左心室内径更大[(56．2±9．5) mm对(60．8±7．9) mm,P=0．03]；左心室射血分数(LVEF)更低(0．48±0．13对0．40±0．09,P=0．04),β受体阻滞剂使用的比例更低(91．8%对71．8%,P=0．01)。在随访期间,ES组患者死亡或心脏移植的发生率显著高于未发生ES的患者。结论 ES在ICD植入术后患者中并不罕见且常反复发生,心功能低下、β受体阻滞剂应用不足会增加ES的风险；ES患者中死亡及需要心脏移植的比例增高。
목적：본문지재관찰식입형심률전복제전기( ICD)식입후전풍폭( ES)적발생솔화림상특정。방법회고성분석2003년1월지2010년10월재부외의원식입ICD적134례환자술후적림상치료화ICD정공자료,비교발생ES화미발생ES적환자기출심장병、심공능、약물치료화예후적차이。결과17．4%적ICD환자발생과ES사건,기중70%환자사건수≥2,89．5%적ES시유우실성심동과속( VT)인기적。여미발생ES적환자상비,발생ES환자적좌심실내경경대[(56．2±9．5) mm대(60．8±7．9) mm,P=0．03]；좌심실사혈분수(LVEF)경저(0．48±0．13대0．40±0．09,P=0．04),β수체조체제사용적비례경저(91．8%대71．8%,P=0．01)。재수방기간,ES조환자사망혹심장이식적발생솔현저고우미발생ES적환자。결론 ES재ICD식입술후환자중병불한견차상반복발생,심공능저하、β수체조체제응용불족회증가ES적풍험；ES환자중사망급수요심장이식적비례증고。
Objective The purpose of this study was to determine the incidence and risk factors of electrical storms ( ES) in patients who received implantable cardioverter defibrillator( ICD) . Methods We ret-rospectively assessed 134 ICD patients’ medical records and ICD programmed records. ES was defined as the occurrence of three or more ventricular tachyarrhythmia episodes that needs ICD therapy. Results seventeen point four percent of the patients experienced at least one ES episode. In most ES cases,the index arrhythmia was ventricular tachycardia. Compared with non-ES patients,ES patients had depressed left ventricular ejection fraction(LVEF 0. 48±0. 13 vs. 0. 40±0. 09,P=0. 04),enlarged left ventricular diameter[(56. 2±9. 5)mm vs. (60. 8±7. 9) mm,P=0. 03],insufficient use of β-blocker(91. 8% vs. 71. 8%,P=0. 01). And ES episode could increase the risk of combined incidence of mortality and heart transplantation. Conclusion ES events are not rare in a ‘ real-world’ patient population with ICDs. It is most likely to occur in patients with lower LVEF, and insufficient use of β-blocker would increase the risk of ES.