摘要
目的了解因遗传性心律失常植入心律转复除颤器（ICD）的患者术后情况及ICD的治疗效果。方法回顾性分析阜外医院从2004年6月到2011年6月诊断为长QT综合征、Brugada综合征、致心律失常性右心室心肌病（ARVC）以及肥厚型心肌病并且植入了ICD的全部患者，通过定期随访及调阅患者的ICD内存储的数据了解患者术后的一般情况、ICD植入术后室性心律失常的发作情况以及ICD的工作情况。结果共入选患者43例，其中男25例，女18例，年龄8—78（41．5±15．8）岁，随访8～84（37．0±20．6）个月。21例（48．8％）患者在随访期内发生室性心动过速／心室颤动（室速／室颤）事件，其中有5例（11．6％）患者发生的室速／室颤事件属于不恰当识别。1例患者在植入ICD后发生未识别事件。ICD共记录到室速／室颤事件382次，植入ICD后首次发生室速／室颤事件的时间为术后1～36（6．4±8．9）个月，84．6％的室速／室颤事件发生于1年内。ICD共启动治疗程序498次，包括抗心动过速起搏381次，同步电复律83次，高能量除颤34次。结论遗传性心律失常患者恶性室性心律失常复发率高且复发早。二级预防植入ICD可有效预防患者猝死的发生。
Objective To investigate the efficacy of implantable cardioverter defibrillator（ICD） in patients with inherited cardiac arrhythmias. Methods A retrospective analysis was conducted in patients with Long-QT syndrome （LQTS）, Brugada syndrome, hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy （ARVC） who received ICDs between June 2004 and June 2011 in Fuwai Hospital. Results Fourty-three patients （58% male, age 41.5 ± 15.8 years）were included. During the follow-up period of （37.0±20. 6） months, a total of 382 episodes of malignant ventricular arrhythmias were documented in 21 patients （48.8%） ,while 5 （11.6%）of whom due to inappropriate detection. One patient had a sustained ventricular tachycardia episode undetected but not leading to a severe event. The average duration from implantation to first malignant ventricular arrhythmias episode was 6.4±8. 9 months. The cumulative event rate was 84. 6% at 1 year follow-up. ICDs delivered 4-98 therapies, consisting of 381 times of ATP, 83 times of CV, and 34 times of SHOCK. Conclusions Patients with inherited cardiac arrhythmias have a high recurrence rate of ventricular malignant arrhythmias, and ICD is effective in preventing these patients from sudden cardiac death. However, inappropriate detection/therapy is an outstanding problem in this population.
出处
《中华心律失常学杂志》
2012年第3期176-179,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
植入型心律转复除颤器
心脏性猝死
随访
离子通道病
心肌病
Implantable cardioverter defibrillator
Sudden cardiac death
follow-up
Channelopathy
Cardiomyopathy
