Trappe H J, Pfitzner P, Figuth H G, Wenzlaff P, Kielblock B, Klein H
Department of Cardiology, University Hospital Hannover, Germany.
Pacing Clin Electrophysiol. 1994 Nov;17(11 Pt 2):2172-7. doi: 10.1111/j.1540-8159.1994.tb03821.x.
It has been shown that conventional antiarrhythmic drug treatment is debatable, and there is growing interest in nonpharmacological techniques. We studied the outcome of 554 patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) who underwent nonpharmacological techniques from March 1980 to June 1994 at our institution. Catheter ablation was performed in 51 patients (G1), map guided surgery in 147 (G2), and cardioverter defibrillator implantation (ICD) in 356 (G3). During a mean follow-up of 37 +/- 12 (< 1-137) months, incidence of sudden death (G1 4%, G2 6%, G3 3%) and cardiac death (G1 7%, G2 16%, G3 8%) were relatively low, and there was no significant differences between G1-G3. VT/VF recurrences occurred more frequently in G1 (57%) than in G2 (18%) (P < 0.01). ICD discharges occurred in 69% of patients. We conclude that nonpharmacological techniques lead to low sudden death rates; however, there is a high rate of recurrence in G1. Risk stratification is necessary to select the ideal therapy for each individual patient.
已表明传统抗心律失常药物治疗存在争议，且对非药物技术的兴趣日益增加。我们研究了1980年3月至1994年6月在我院接受非药物技术治疗的554例室性心动过速（VT）或室性颤动（VF）患者的治疗结果。51例患者（G1组）接受了导管消融，147例（G2组）接受了标测引导手术，356例（G3组）接受了心脏复律除颤器植入（ICD）。在平均37±12（<1 - 137）个月的随访期间，猝死发生率（G1组4%，G2组6%，G3组3%）和心源性死亡发生率（G1组7%，G2组16%，G3组8%）相对较低，且G1 - G3组之间无显著差异。VT/VF复发在G1组（57%）比G2组（18%）更频繁发生（P < 0.01）。69%的患者发生了ICD放电。我们得出结论，非药物技术导致猝死率较低；然而，G1组复发率较高。有必要进行风险分层以选择适合每个患者的理想治疗方法。
