Zilo P, Gross J N, Benedek M, Fisher J D, Furman S
Department of Cardiothoracic Surgery, Montefiore Medical Center, Bronx, New York 10467.
Pacing Clin Electrophysiol. 1991 Feb;14(2 Pt 2):273-9. doi: 10.1111/j.1540-8159.1991.tb05106.x.
Fifty-six consecutive patients who underwent initial implantation of an implantable cardioverter defibrillator (AICD) between May 1982 and January 1990 were analyzed. During a mean follow-up of 31.5 +/- 25 months, 32 (60%) patients experienced a spontaneous shock from their device. Their clinical characteristics and survival were compared to those of 21 patients without shocks. No statistically significant difference was found in the distribution between the two groups in age, sex, cardiac diagnosis, New York Heart Association Class, presenting arrhythmia, or mean follow-up (F/U). The group with shocks had a higher incidence of previous MI (P = 0.021) a lower mean ejection fraction (P = 0.023) and had been tried on a greater number of medical regimens (P = 0.003). The 1-, 3-, and 5-year cumulative survivals were 84%, 69%, and 37% in the group with shocks and 93%, 93%, and 93% for the group without shocks. Our data suggests that the occurrence of a shock is a negative prognostic indicator and that the excellent prognosis of patients without shocks contributes in large part to the favorable outcome of AICD patients.
对1982年5月至1990年1月期间连续56例行植入式心脏复律除颤器（AICD）初次植入的患者进行了分析。在平均31.5±25个月的随访期间，32例（60%）患者经历了来自其设备的自发电击。将他们的临床特征和生存率与21例未发生电击的患者进行了比较。两组在年龄、性别、心脏诊断、纽约心脏协会分级、出现的心律失常或平均随访时间（F/U）方面的分布没有统计学上的显著差异。发生电击的组既往心肌梗死发生率较高（P = 0.021），平均射血分数较低（P = 0.023），并且尝试过的药物治疗方案更多（P = 0.003）。发生电击组的1年、3年和5年累积生存率分别为84%、69%和37%，未发生电击组分别为93%、93%和93%。我们的数据表明，电击的发生是一个不良预后指标，并且未发生电击患者的良好预后在很大程度上促成了AICD患者的良好结局。
