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[抗心动过速射频起搏器。44例经验]

[Anti-tachycardia radiofrequency pacemakers. Experience with 44 cases].

作者信息

Fontaine G, Moro-Serrano C, Menezes-Falcao L, Todorova M, Frank R, Tonet J L, Grosgogeat Y

出版信息

Arch Mal Coeur Vaiss. 1986 Nov;79(12):1696-702.

PMID:3105481
Abstract

Programmed cardiac stimulation may be performed externally using implanted radiofrequency receiving capsules. Between 1979 and 1984, 44 patients underwent implantation of these devices, 12 with atrial leads for supraventricular tachycardias (8 orthodromic reciprocating tachycardias, 1 intranodal junctional tachycardia and 3 atrial tachycardias), and 32 with ventricular leads for ventricular tachycardias. In the first case the transmitter was given to the patients so that they could terminate the tachycardias themselves. In the second case, the transmitter was kept in the cardiology department. All patients were also prescribed prophylactic antiarrhythmic drugs. The radiofrequency method was effective in 11 out of 12 cases of supraventricular tachycardia with a follow-up period ranging from 24 to 65 months (average 45 +/- 11 months). In the ventricular tachycardia group, the device was used in 11 patients to terminate ventricular tachycardia and in all patients to evaluate the efficacy of the antiarrhythmic therapy by provocative programmed stimulation with a follow-up ranging from 2 to 81 month (average 24 +/- 20 months). This palliative therapeutic method has reduced the number of hospital admissions in these patients. The indications are relatively few because of the efficacy of currently available antiarrhythmic agents and the possibility of radical treatment of tachyarrhythmias by surgery or catheter ablation.

摘要

程控心脏刺激可通过植入式射频接收胶囊在体外进行。1979年至1984年间,44例患者植入了这些装置,其中12例植入心房电极用于治疗室上性心动过速(8例正向折返性心动过速、1例结内交界性心动过速和3例房性心动过速),32例植入心室电极用于治疗室性心动过速。在第一种情况下,将发射器交给患者,以便他们能够自行终止心动过速。在第二种情况下,发射器保存在心脏病科。所有患者还均开了预防性抗心律失常药物。在12例室上性心动过速患者中,射频方法在11例中有效,随访期为24至65个月(平均45±11个月)。在室性心动过速组中,该装置用于11例患者终止室性心动过速,并用于所有患者通过激发性程控刺激评估抗心律失常治疗的疗效,随访期为2至81个月(平均24±20个月)。这种姑息性治疗方法减少了这些患者的住院次数。由于目前可用的抗心律失常药物的疗效以及通过手术或导管消融根治快速性心律失常的可能性,其适应证相对较少。

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