Garcia-Moran E, Mont L, Cuesta A, Matas M, Brugada J
Arrhythmia Section, Hospital Clínic Universitari, Barcelona, Spain.
Eur Heart J. 2002 Jun;23(11):901-7. doi: 10.1053/euhj.2001.3073.
To determine the effectiveness of the implantable cardioverter defibrillator (ICD) in preventing recurrence of syncope in patients with structural heart disease, previously unexplained syncope and inducible ventricular arrhythmias.
Thirty-eight patients with syncope, structural heart disease and inducible arrhythmias had an ICD implanted. All ICDs delivered antitachycardia pacing and shocks of adjusted energy. Detection and therapy were programmed according to uniform criteria.
The mean age of the patients was 63+/-11 years and most of them were male (36/38). After a mean follow-up of 28+/-15 (4-61) months, six patients died and one underwent heart transplantation. Syncope recurred in three patients, but in none of them was it caused by an arrhythmic event. In 18 patients, 113 episodes of ventricular tachycardia/ventricular fibrillation were detected and appropriately treated by the ICD. The mean time from implant until first appropriate therapy was 18+/-14 months. The actuarial probability of receiving appropriate therapy was 20% and 42% at 12 and 24 months, respectively.
In patients with unexplained syncope, structural heart disease and inducible arrhythmias, ICD prevents syncope associated with arrhythmic events. Frequent effective use of antitachycardia pacing and shocks of adjusted energy seem essential to this aim.
确定植入式心脏复律除颤器（ICD）在预防结构性心脏病、既往不明原因晕厥且可诱发室性心律失常患者晕厥复发方面的有效性。
38例患有晕厥、结构性心脏病且可诱发心律失常的患者植入了ICD。所有ICD均能进行抗心动过速起搏并发放能量可调的电击。根据统一标准对检测和治疗进行编程。
患者的平均年龄为63±11岁，大多数为男性（36/38）。平均随访28±15（4 - 61）个月后，6例患者死亡，1例接受了心脏移植。3例患者晕厥复发，但均非由心律失常事件所致。18例患者检测到113次室性心动过速/心室颤动发作，并由ICD进行了适当治疗。从植入到首次适当治疗的平均时间为18±14个月。在12个月和24个月时接受适当治疗的精算概率分别为20%和42%。
对于不明原因晕厥、结构性心脏病且可诱发心律失常的患者，ICD可预防与心律失常事件相关的晕厥。频繁有效使用抗心动过速起搏和能量可调的电击似乎对实现这一目标至关重要。
