Favale S, Dicandia C D, Barletta A, Forleo C, Luzzi G, Tunzi P, Rizzon P
Istituto di Cardiologia, Università degli Studi, Bari.
Cardiologia. 1996 Nov;41(11):1079-87.
From March 1992 to April 1996 a pectoral biphasic transvenous implantable cardioverter defibrillator without subcutaneous leads was implanted in 35 patients with life threatening ventricular tachyarrhythmias. Mean age was 58 +/- 9 years; 23 patients had coronary artery disease, 10 non ischemic dilated cardiomyopathy and 2 arrhythmogenic right ventricular dysplasia. All were in NYHA functional class I and II and 4 in class III: mean ejection fraction was 35 +/- 12%. The mean duration of the implantation procedure was 85 +/- 35 min. The mean defibrillation threshold, measured in 23 active-CAN devices was 8.8 +/- 5 J. There were no operative complications except in one case of transient ischemic electromechanical dissociation. The mean hospital stay from the time of implant to predischarge evaluation was 6.2 +/- 2 days. The average follow-up period was 18.5 +/- 11 months. Two patients had non sudden and non arrhythmic cardiac death in the third and sixth month, respectively. In 19 patients 171 implantable cardioverter defibrillator interventions were reported: in 5 patients five inappropriate interventions were reported and in the remaining 14 were reported: 35 ventricular fibrillation and 131 ventricular tachycardia. The short duration of the procedure, brief hospitalization with very low perioperative morbidity, high efficacy and low mid-term complications give a new image to this therapeutic option.
1992年3月至1996年4月，35例有危及生命的室性快速性心律失常的患者植入了无皮下导线的双相胸壁经静脉植入式心脏复律除颤器。平均年龄为58±9岁；23例患者患有冠状动脉疾病，10例患有非缺血性扩张型心肌病，2例患有致心律失常性右心室发育不良。所有患者均处于纽约心脏协会（NYHA）心功能I级和II级，4例为III级：平均射血分数为35±12%。植入手术的平均持续时间为85±35分钟。在23台有源CAN装置中测量的平均除颤阈值为8.8±5焦耳。除1例短暂性缺血性电机械分离外，无手术并发症。从植入到出院前评估的平均住院时间为6.2±2天。平均随访期为18.5±11个月。两名患者分别在第三个月和第六个月发生非猝死性和非心律失常性心脏死亡。19例患者报告了171次植入式心脏复律除颤器干预：5例患者报告了5次不适当干预，其余14例报告了：35次心室颤动和131次室性心动过速。手术时间短、住院时间短、围手术期发病率极低、疗效高和中期并发症低，为这种治疗选择赋予了新的形象。
