Watkins L, Reid P R, Platia E V, Mower M M, Griffith L S, Mirowski M
Am J Surg. 1983 Jun;145(6):752-5. doi: 10.1016/0002-9610(83)90133-2.
Twenty-eight patients who survived multiple arrhythmic cardiac arrest refractory to medical therapy underwent implantation of the automatic defibrillator without additional antiarrhythmic surgery. Lateral thoracotomy was used for implantation in 14 patients and the subxiphoid technique was used in 14. There was no operative mortality and surgical complications were minimal. The longest follow-up was 29 months and the average was 14 months. The implanted device correctly identified and reverted 50 episodes of spontaneous malignant ventricular tachyarrhythmias in six hospitalized patients. After discharge, 20 episodes of automatic out-of-hospital resuscitations occurred in eight patients. Kaplan-Meier survival curves, based on the assumption that out-of-hospital defibrillations would otherwise have been lethal, indicated an expected 1 year mortality of 60 percent. Seven deaths were in fact observed in this period for an actual mortality rate of 30 percent. We conclude that automatic defibrillation is clearly feasible in man and appears to increase survival in selected high-risk patients.
28例经药物治疗难治的多次心律失常性心脏骤停存活患者接受了自动除颤器植入，未进行额外的抗心律失常手术。14例患者采用侧胸壁切开术植入，14例采用剑突下技术。无手术死亡，手术并发症极少。最长随访时间为29个月，平均为14个月。植入装置正确识别并逆转了6例住院患者的50次自发性恶性室性快速心律失常发作。出院后，8例患者发生了20次自动院外复苏。基于院外除颤否则将致命的假设绘制的Kaplan-Meier生存曲线显示，预计1年死亡率为60%。在此期间实际观察到7例死亡，实际死亡率为30%。我们得出结论，自动除颤在人体中显然是可行的，并且似乎能提高选定高危患者的生存率。
