Zaim S, Connolly M, Roman-Gonzalez J, Walter P, Craver J, Jones E
Department of Medicine, Emory University Hospital, Atlanta, Georgia.
Am J Med Sci. 1994 Mar;307(3):185-9. doi: 10.1097/00000441-199403000-00005.
Over a 5-year period, 110 cardioverter-defibrillators (109 epicardial, 1 transvenous) were implanted consecutively in selected patients with ventricular tachyarrhythmias. The perioperative course of this patient population was examined to determine the associated morbidity and mortality of the procedure. Patients were predominantly male, with coronary artery disease and a decreased left ventricular ejection fraction. Most underwent median sternotomy for implantable cardioverter defibrillator implantation. The incidence of perioperative mortality was found to be 2.7%. New-onset atrial fibrillation or flutter occurred in 17.3% of the patients during the postoperative period and aggravation of ventricular tachyarrhythmias in 19.1%. The ICD system became infected in 2.7% of the patients and the mediastinal incision site infected in 2.4%. Pneumonia developed in 4.5%. Other complications included significant blood loss, ICD pocket hematomas, and lead dislodgement. There is an appreciable incidence of morbidity and mortality associated with ICD implantation.
在5年期间，为选定的室性快速性心律失常患者连续植入了110台心脏复律除颤器（109台心外膜式，1台经静脉式）。对这一患者群体的围手术期过程进行了检查，以确定该手术相关的发病率和死亡率。患者以男性为主，患有冠状动脉疾病且左心室射血分数降低。大多数患者接受了正中胸骨切开术以植入植入式心脏复律除颤器。围手术期死亡率为2.7%。术后期间，17.3%的患者出现新发房颤或房扑，19.1%的患者室性快速性心律失常加重。2.7%的患者发生植入式心脏复律除颤器（ICD）系统感染，2.4%的患者纵隔切口部位感染。4.5%的患者发生肺炎。其他并发症包括大量失血、ICD囊袋血肿和导线移位。ICD植入相关的发病率和死亡率相当可观。
