Waldecker B, Brachmann J, Schmitt C, Killat H, Saggau W, Stertmann W A, Dapper F, Hehrlein F W, Tillmanns H, Kübler W
Medizinische und Herzchirurgische Kliniken, Universitäten Heidelberg und Giessen.
Z Kardiol. 1994 Apr;83(4):283-92.
The purpose of this retrospective study is the analysis of dysrhythmias following internal cardioversion/defibrillation of ventricular tachycardia (VT) or fibrillation (VF) and to discuss their relevance to the therapy with automatic implantable devices. Therefore, 304 internal conversions of VT/VF during and/or after implantation of automatic defibrillators were evaluated in 51 patients. Significant post-shock arrhythmias (bradycardia, atrial fibrillation, non-sustained VT of > or = 10 cycles) were absent after 89% of internal shocks. Pauses of > 2 s were observed in 2/9 patients without VVI-back-up pacing. The heart rate was > or = 50 bpm in 10/51 patients. Atrial fibrillation occurred in 7 patients. Non-sustained, mostly polymorphic VT consisting of > or = 10 cycles followed 18/304 (6%) internal shocks in 13 patients. The VT rate was > or = 200/min in 17/18 episodes and triggered an inadequate shock once. The incidence of non-sustained VT post-shock was unrelated to shock energy, type, and duration of the converted arrhythmia. In conclusion, automatic implantable devices should provide back-up pacing. Tachycardic rhythms can mislead automatic interpretation of the effect of internal shocks.
这项回顾性研究的目的是分析心室性心动过速（VT）或心室颤动（VF）经体内心脏复律/除颤后的心律失常情况，并探讨其与自动植入式装置治疗的相关性。因此，我们对51例患者在植入自动除颤器期间和/或之后进行的304次VT/VF体内复律情况进行了评估。89%的体内电击后未出现明显的电击后心律失常（心动过缓、心房颤动、持续时间≥10个周期的非持续性VT）。在2/9例无VVI备用起搏的患者中观察到了>2秒的停搏。10/51例患者的心率≥50次/分钟。7例患者发生了心房颤动。13例患者中，18/304次（6%）体内电击后出现了由≥10个周期组成的非持续性、大多为多形性VT。17/18次发作的VT频率≥200次/分钟，有一次引发了不适当的电击。电击后非持续性VT的发生率与电击能量、转复的心律失常类型和持续时间无关。总之，自动植入式装置应提供备用起搏。心动过速性心律可能会误导对体内电击效果的自动解读。
