高い défibrillation 値を持つ患者の臨床的特徴と結果. マルチセンター研究です
A E Epstein1, K A Ellenbogen, K A Kirk
1Division of Cardiovascular Disease, University of Alabama, Birmingham 35294.
Circulation
|October 1, 1992
まとめ
高い défibrillation 値を持つ患者はリスクが高くなりますが,インプラント可能な心臓変容器- défibrillateur (ICD) のインプラントは生存率を改善します. 抗リズム薬の使用は高値に寄与し,ICD治療の最適化の必要性を強調する可能性があります.
科学分野:
- 心臓病学 心臓病学
- 医療機器 医療機器について
- 電気生理学 電気生理学
背景:
- 埋め込み式心臓変容器-除細動器 (ICD) での成功的な除細動は,除細動の値を超えたショックを必要とします.
- 高い défibrillation 値と影響を受けた患者のアウトカムの予測要因を特定することは極めて重要です.
研究 の 目的:
- 高度の défibrillation 値を予測する臨床的特徴を特定する.
- 高い défibrillation 値を有する患者のアウトカムを記述する.
主な方法:
- 12つのセンターから1,946人の患者の記録を遡及的に分析した.
- デフィブリレーションの値≥25Jを有する90人の患者 (4.6%) を特定した.
- ICDインプラントを入れている患者と入れていない患者のアウトカムの比較.
主要な成果:
- 高い défibrillation 値を持つ患者は,主に男性で,エジェクション分子が低下し,冠動脈疾患の高い流行率が認められました.
- 抗リズム薬,特にアミオダロンの使用は一般的でした.
- ICDインプラントは,ICDなしの患者と比較して,2年および5年生存率を大幅に改善しました (81% vs. 36% 2年; 73% vs. <32ヶ月 5年).
結論:
- 抗リズム薬の使用は,高揚した défibrillation 値と関連している可能性があります.
- アリズム不良による死亡は,ICDでも,高値の患者にとって重要なリスクであり続けています.
- ICDパッチの配置を厳格なテストで最適化することで,除細動の安全性を高めることができます.
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