Trappe H J, Wenzlaff P, Klein H, Pfitzner P, Fieguth H G, Kielblock B, Lichtlen P R
Abteilung Thorax-, Herz- und Gefässchirurgie, Medizinische Hochschule Hannover.
Z Kardiol. 1995 Mar;84(3):222-31.
Since January 1984, the cardioverter-defibrillator (ICD) has been implanted in 353 patients (pts). Epicardial ICD implantation was performed in 207 pts and 146 pts underwent non-thoracotomy ICD implant. Overall operative mortality was 3% (12/353 pts) and was significantly higher in pts with epicardial ICD implantation (11/207 pts, 5%) than in patients who received non-thoracotomy ICDs (1/146 pts, < 1%) (p < 0.05). During a mean follow-up of 25 +/- 23 months, 63 pts (19%) died: 8 pts (0.8% per year) from sudden arrhythmic death and 6 pts (0.8% per year) suddenly without an underlying arrhythmia. Cardiac death was observed in 36 pts (4% per year) and 13 pts (2% per year) died from other causes. Appropriate ICD discharges were observed in 245 pts (72%) with a mean incidence of 22 +/- 44 IC discharges per pt. In pts with third-generation ICDs, 3,542 ventricular tachyarrhythmias (VTA) were observed and terminated by primary ICD shocks in 778 VTA (22%). Antitachycardia pacing was attempted in 2,764 VTA (78%) and was successful in 2,484 VTA (90%).
自1984年1月以来，已为353例患者植入了心脏复律除颤器（ICD）。207例患者接受了心外膜ICD植入，146例患者接受了非开胸ICD植入。总体手术死亡率为3%（12/353例患者），心外膜ICD植入患者的手术死亡率（11/207例患者，5%）显著高于接受非开胸ICD植入的患者（1/146例患者，<1%）（p<0.05）。在平均25±23个月的随访期间，63例患者（19%）死亡：8例患者（每年0.8%）死于心律失常性猝死，6例患者（每年0.8%）无潜在心律失常突然死亡。观察到36例患者（每年4%）发生心源性死亡，13例患者（每年2%）死于其他原因。245例患者（72%）观察到ICD适当放电，平均每位患者IC放电发生率为22±44次。在第三代ICD患者中，观察到3542次室性快速心律失常（VTA），其中778次VTA（22%）被ICD首次电击终止。对2764次VTA（78%）尝试进行抗心动过速起搏，其中2484次VTA（90%）成功。
