Fonger J D, Guarnieri T, Griffith L S, Veltri E, Levine J, Mower M, Mirowski M, Grunwald L, Watkins L
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD.
Ann Thorac Surg. 1988 Jul;46(1):13-9. doi: 10.1016/s0003-4975(10)65843-2.
Myocardial revascularization and implantation of the automatic implantable cardioverter defibrillator (AICD) have individually been shown to improve survival in patients after sudden cardiac death. Their combined role has not been well defined. Twenty-three survivors of sudden death underwent revascularization and AICD implantation at an average age of 59 years. The initial arrest was caused by ventricular fibrillation in 15 and ventricular tachycardia in 8. Exercise stress tests, ambulatory ECGs, and electrophysiological monitoring with programmed electrical stimulation were done preoperatively and postoperatively. Follow-up averaged 24 months with a two-year survival of 91%. Eight patients (35%) required AICD resuscitation an average of 8 months postoperatively, and electrophysiological testing did not accurately predict arrhythmia recurrence. The addition of AICD implantation to revascularization substantially improves survival of patients with sudden cardiac death.
心肌血运重建术和植入自动植入式心脏复律除颤器（AICD）已分别被证明可提高心脏性猝死患者的生存率。它们的联合作用尚未明确界定。23名心脏性猝死幸存者平均年龄59岁，接受了血运重建术和AICD植入术。最初的心脏骤停由室颤导致的有15例，由室性心动过速导致的有8例。术前和术后均进行了运动负荷试验、动态心电图检查以及程控电刺激的电生理监测。随访平均24个月，两年生存率为91%。8例患者（35%）术后平均8个月需要AICD复苏，且电生理检查未能准确预测心律失常复发。在血运重建基础上增加AICD植入可显著提高心脏性猝死患者的生存率。
