Luceri R M, Habal S M, Castellanos A, Thurer R J, Waters R S, Brownstein S L
Interventional Arrhythmia Center, Holy Cross Hospital, Fort Lauderdale, Florida.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):2015-22. doi: 10.1111/j.1540-8159.1988.tb06343.x.
Fifty patients underwent primary implantation of an automatic implantable cardioverter defibrillator between August 1983 and April 1988 and were entered into a long-term surveillance program. There were a total of 14 deaths (28%) in the entire group occurring at a mean of 8.7 months postimplantation. Eleven deaths were cardiac and three were noncardiac (two pneumonia, one leukemia). The group of deceased patients were similar to the survivors in all respects except for a statistically lower ejection fraction (23% vs 32%) at the time of implantation. In addition, 13/14 (93%) of the deceased patients experienced at least one appropriate AICD discharge at a mean of 4.5 months post implantation. Recorded ECGs at the time of death revealed that most of the sudden deaths were due to electromechanical dissociation and not to AICD-treatable arrhythmias. These data suggest therefore that death in AICD patients is usually cardiac, due primarily to low ejection fraction and occurs in patients who have previously received AICD discharges.
1983年8月至1988年4月期间，50例患者接受了植入式自动心脏复律除颤器的初次植入，并进入了长期监测项目。整个组共有14例死亡（28%），平均发生在植入后8.7个月。11例死亡为心脏性死亡，3例为非心脏性死亡（2例肺炎，1例白血病）。除了植入时射血分数在统计学上较低（23%对32%）外，死亡患者组在各方面与存活者相似。此外，14例死亡患者中有13例（93%）在植入后平均4.5个月至少经历了一次合适的AICD放电。死亡时记录的心电图显示，大多数猝死是由于电机械分离，而非AICD可治疗的心律失常。因此，这些数据表明，AICD患者的死亡通常是心脏性的，主要归因于射血分数低，且发生在先前接受过AICD放电的患者中。
