Jessurun E R, Hutten B A, van Hemel N M, Kelder J C, Defauw J J, Bakema H
St.-Antonius Ziekenhuis, afd. Cardiologie, Nieuwegein.
Ned Tijdschr Geneeskd. 1997 Jul 26;141(30):1475-80.
To describe the results of treatment of patients with a life-threatening arrhythmia by implantation of an second generation implantable cardioverter defibrillator with transvenous electrodes.
Descriptive.
St.-Antonius Hospital, Nieuwegein, the Netherlands.
In the period October 1991-February 1996 the ICD with transvenous electrodes was implanted in 44 patients. After a year the quality of life was assessed by written questionnaire.
The in-hospital mortality was 1/44 (2%), without peroperative death. During follow-up 4 patients died: 3 due to congestive heart failure and 1 due to sudden cardiac death. Within one year 50% of the patients had a therapeutical ICD discharge. In 30/44 (68%) patients antiarrhythmic drugs were prescribed to reduce the number of ICD discharges or because they were suffering from paroxysmal atrial fibrillation with high heart rates, which could result in an inappropriate ICD discharge. Quality of life analysis showed a good acceptance of the ICD, although 86% of the patients considered it a very serious limitation that they were not allowed to drive a motor vehicle anymore.
The ICD constitutes a major step forward in the treatment of life-threatening ventricular arrhythmias because the implantation is easier and follow-up shows adequate antiarrhythmic effects and survival.
描述采用经静脉电极的第二代植入式心脏复律除颤器治疗危及生命的心律失常患者的结果。
描述性研究。
荷兰奈沃肯的圣安东尼医院。
在1991年10月至1996年2月期间，为44例患者植入了经静脉电极的植入式心脏复律除颤器。一年后通过书面问卷评估生活质量。
住院死亡率为1/44（2%），无围手术期死亡。随访期间有4例患者死亡：3例死于充血性心力衰竭，1例死于心源性猝死。一年内50%的患者有治疗性植入式心脏复律除颤器放电。在30/44（68%）例患者中，开具了抗心律失常药物以减少植入式心脏复律除颤器放电次数，或者因为他们患有阵发性房颤且心率快，这可能导致不适当的植入式心脏复律除颤器放电。生活质量分析显示患者对植入式心脏复律除颤器的接受度良好，尽管86%的患者认为不再允许驾驶机动车是一个非常严重的限制。
植入式心脏复律除颤器在治疗危及生命的室性心律失常方面向前迈出了重要一步，因为植入更容易，随访显示有足够的抗心律失常效果和生存率。
