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埋藏式心脏复律除颤器临床应用分析 |
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任自文1 宋有城2 朱俊1 丁燕生1 陈健1 吴林1 袁贤奇2 李建冬2 张钧华1
摘要 9例药物难治性室性心动过速(VT)病人接受埋藏式心脏复律除颤器(ICD)治疗，其中冠心病7例，扩张型心肌病、房间隔缺损修补术后各1例。8例术前有电击复律/除颤史。9例术前、术后均接受胺碘酮治疗，随访9.8±8.0个月，7例经ICD储存资料证实共发生VT 666次，100%被ICD有效终止，首次治疗程序成功率为97%。4例VT经电击复律，2例因窦性心动过速而误放电，6例有疼痛与恐惧感。1例同时埋置了ICD与单极电极导线起搏器，随访16个月未发现任何不良的相互作用。心理障碍是ICD治疗值得重视的问题，医生应协助病人尽量缩短心理调整过程，使之尽快对埋置的ICD进行适应。
关键词 心脏复律除颤器，埋藏式 心动过速，室性 起搏器
The Follow-up of 9 Patients With Implantable Cardioverter-Defibrillators
Ren Ziwen*,Song Youcheng**,Zhu Jun**,et al
(* Department of Cardiology,The First Hospital,Beijing Medical University,Beijing,10034)
(** Department of cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing,100037)
Abstract Implantable cardioverter-defibrillators (ICD) were implanted in nine patients with drug refractory ventricular tachycardias(VT),seven with coronary heart disease,one with dilated cardiomyopathy,one with post surgical repaired atrial septal defect.Eight patients experienced electrical cardioversion/defibrillations before ICD implantation.All the nine patients took amiodarone before and after ICD implantation.The average duration of follow-up was 9.8±8.0 months.The storage data revealed that 666 episodes of VT were detected and one hundred percent of them terminated by ICD in seven patients,the successful rate of the first treatment programs was 97%.Six patients experienced cardioversion after implantation.Four of them for VT and two for false delivery because of sinus tachycardias,all of them sufferred pain and developed sensation of horror to shock.There was a combined use of ICD and unipolar pacemaker in one patient and no poor interaction was found during follow-up of sixteen months.The psychological disorder is a valuable problem of ICD treatment and the doctors should help the patients with ICD adapt themself to ICD at the shortest time.
Key words Cardioverter-defibrillator ,implantable Tachycardia,ventricular[1] [2] 下一页
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