Porterfield J G, Porterfield L M, Bray L
Methodist Hospital, Memphis, Tennessee.
Pacing Clin Electrophysiol. 1991 Feb;14(2 Pt 2):263-6. doi: 10.1111/j.1540-8159.1991.tb05104.x.
Seventy-seven patients with drug refractory ventricular tachycardia (57) and ventricular fibrillation (20) received the implantable defibrillator. There were 55 men and 22 women with a mean age of 63 +/- 10 years. The anatomical diagnoses were coronary artery disease in 61 patients, cardiomyopathy in 15 patients, and aortic stenosis in one patient. The mean ejection fraction was 32 +/- 12%. Concurrent surgery at defibrillator implantation was coronary bypass in eight patients and aortic valve replacement in one patient. There were no intraoperative mortalities. The mean ventricular fibrillation termination threshold was 13 +/- 6 joules. During a follow-up period of 16 +/- 10 months (range 2-40 months) four patients died: electrical mechanical dissociation (two patients), respiratory failure, and sepsis. Thirty-eight patients (51%) continued receiving antiarrhythmic drug therapy, with quinidine sulfate and procainamide being the most frequently utilized agents. Fifty-four patients (72%) have received a mean of 9 +/- 10 shocks (range 1-44). Implantable defibrillators are often needed in patients seen in large community hospitals. This technology can be administered successfully in this setting with complications and results comparable to those reported from university hospitals. Implantable defibrillators are effective in preventing arrhythmic death and can be used with low risk to the patients.
77例药物难治性室性心动过速（57例）和心室颤动（20例）患者接受了植入式除颤器治疗。其中男性55例，女性22例，平均年龄63±10岁。解剖学诊断为冠状动脉疾病61例，心肌病15例，主动脉瓣狭窄1例。平均射血分数为32±12%。植入除颤器时同期进行的手术包括8例冠状动脉搭桥术和1例主动脉瓣置换术。无术中死亡病例。平均心室颤动终止阈值为13±6焦耳。在16±10个月（范围2 - 40个月）的随访期内，4例患者死亡：电机械分离（2例）、呼吸衰竭和脓毒症。38例患者（51%）继续接受抗心律失常药物治疗，硫酸奎尼丁和普鲁卡因酰胺是最常用的药物。54例患者（72%）平均接受了9±10次电击（范围1 - 44次）。大型社区医院的患者常常需要植入式除颤器。在这种情况下，这项技术可以成功实施，并发症和结果与大学医院报告的相当。植入式除颤器在预防心律失常性死亡方面有效，且对患者的风险较低。
