植入型心律转复除颤器治疗室性快速心律失常的临床应用Clinical application of implantable cardioverter defibrillator (ICD) in treatment of rapid venticular ourhythria
蔡飞,陈松,顾刚,吴立群
摘要(Abstract):
目的探讨植入型心律转复除颤器(ICD)对室性快速心律失常的治疗效果以及随访过程中所遇到的问题。方法48例植入ICD患者(其中8例为双腔ICD),根据患者室性心动过速(VT)/心室颤动(VF)发作时的频率及对血流动力学的影响确定方法和参数,并对植入ICD患者定期随访。结果48例患者顺利植入ICD,无并发症,在随访1~38个月中,患者共发作VT/VF 1 025次(VT764次,占74.5%;VF 261次,占25.5%),其中1 009次(98.4%)治疗成功,16次在ICD充电结束前自行终止。764次VT中,658次(86.1%)经抗心动过速起搏(ATP)终止,106次(13.9%)经低能量复律(CV)终止。261次VF中,经高能量除颤(DF)均终止。6例患者发生误放电19次,8例双腔ICD患者无误放电。结论ICD的疗效是确定的。但单腔ICD常会发生误识别、误放电,随访和及时调整参数可避免或减少此类情况发生。双腔ICD提高了对室上性心律失常的识别能力,从而减少误发电。同时应合理应用抗心律失常药物,高度重视ICD患者的心理治疗。
关键词(KeyWords): 除颤器,植入型;心动过速,室性;心室颤动;随访研究
基金项目(Foundation):
作者(Author): 蔡飞,陈松,顾刚,吴立群
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