摘要
目的本文观察植入犁心律转复除颤器（ICD）植入后电风暴的发生率、临床特征、临床治疗。方法回顾性分析了51例接受ICD治疗的病人，随访2～85个月，其中9例病人出现ICD电风暴，比较ICD电风暴组和无ICD电风暴组的年龄、病因左心室射血分数（LVEF）、心功能分级、临床特征、临床治疗方案。结果有电风暴的患者与无电风暴患者相比年龄更大，差异有统计学意义[（69±14）岁对（61±8）岁]；心功能分级（2．7±0．7对2．1±0．6，P〈0．05）差异有统计学意义；两组LVEF（0．38±n09对0．48±0．04，P〈0．05）差异有统计学意义。在本文中导致ICD电风暴的主要因素是心功能的减退。结论有电风暴的病人比没有电风暴的病人年龄更大，心功能更差，LVEF更低。心力衰竭的加重和焦虑导致的交感神经兴奋是电风暴发生主要的原因。抗心律失常药物胺碘酮和美托洛尔是预防和治疗电风暴的主要手段。射频消融可作药物治疗无效后减少电风暴的主要于段。
Objective The purpose of this study was to observe the incidence rate,clinical characteris- tics and management of electrical storm（ES）. Methods Baseline characteristics of 51 ICD treated patients were retrospectively analyzed. Nine patients had experience of ES in the total of 51 during the follow-up of 2 - 85 months. Compared with 42 ES-free patients, age,left ventricular eject fraction NYHA class was observed, meanwhile clinic characteristics and ES management was observed. Results Univariate analysis identified older age （69 ± 14 vs 61 ± 8 ） depressed left ventricular ejection fraction （LVEF） （ 0. 38 ± 0. 09 vs 0. 48 ± 0. 04 ）, lower heart function （2. 7 ± 0. 7 vs 2. 1 ± 0. 6） as variables significantly associated with an increased risk of ES （p 〈 0. 05）. The main reason of ES is lower function. Conclusions Patients were older, with more advanced congestive heart failure,and tended to have lower LVEF when compared with ICD free patients. Deteriorated CHF and anxiety lead to the activation of sympathetic tone enhancing electrical instability. Amiodarone and β-blockers can reduce the ES. Radiofreqnency catheter ablation（ RFCA ）was a helpful method to reduce ES.
出处
《中华心律失常学杂志》
2009年第2期141-143,共3页
Chinese Journal of Cardiac Arrhythmias
关键词
植入型心律转复除颤器
电风暴
室性心律失常
抗心律失常
hnplantable cardioverter defibrillator
Electrical storm
Ventricular arrhythmia
Anti arrhythmia
