Asenjo R, Oyarzún R, González M, Morales P, Zamorano J, Brunet L, Morris R, Ortiz M
Departamento de Anestesia y Reanimación, Servicio de Cardiocirugía, Hospital Clínico, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 1998 Jul;126(7):803-13.
Implantable defibrillators are the most effective means to prevent sudden death in patients with malignant ventricular tachyarrhythmias. The availability of this type of devices is limited in Chile, due to their high price.
To report the first patients treated with implantable defibrillators in our hospital.
Nine males and one female aged 13 to 65 years old are reported. Three presented with ventricular fibrillation (presenting out of the hospital in three) and the rest had ventricular tachycardia resistant to drugs or radiofrequency ablation.
All implants were performed using intracardiac electrodes. The generator was implanted in the pectoral region in nine and in the abdomen in one. A successful defibrillation was obtained with less than 15 J in four patients, with 20 J in three and with 24 J in three. There were no complications during the procedure. After a 12 months follow up, four patients have been treated by the implantable device. One of these subjects had a ventricular fibrillation in two occasions. One patient died of a bronchopneumonia two years after the implant.
Implantable defibrillators are an effective therapy for the treatment of malignant ventricular arrhythmias with a high risk of sudden death.
植入式除颤器是预防恶性室性心律失常患者猝死的最有效手段。由于价格高昂，这类设备在智利的可及性有限。
报告我院首例接受植入式除颤器治疗的患者。
报告了9名男性和1名女性患者，年龄在13至65岁之间。3例出现心室颤动（3例在院外发病），其余患者患有对药物或射频消融治疗耐药的室性心动过速。
所有植入均使用心内电极。9例将发生器植入胸壁，1例植入腹部。4例患者以小于15焦耳的能量成功除颤，3例以20焦耳，3例以24焦耳成功除颤。手术过程中无并发症发生。随访12个月后，4例患者接受了植入式设备治疗。其中1例患者发生了2次心室颤动。1例患者在植入两年后死于支气管肺炎。
植入式除颤器是治疗有猝死高风险的恶性室性心律失常的有效疗法。
