电风暴预示着非突然死亡:抗节律药与植入式除器 (AVID) 试验
D V Exner1, S L Pinski, D G Wyse
1University of Calgary, Canada. exner@ucalgary.ca
Circulation
|April 25, 2001
概括
电风暴,定义为24小时内多次心室失常发作,显著增加了植入式心脏转换器除器接受者的死亡风险. 这种风险在事件发生后的最初3个月是最高的.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 电风暴,以复发性心室动脉冲动 (VT) 或心室动 (VF) 为特征,是植入式心脏转移器除器 (ICD) 患者的已知的并发症.
- 有限的数据存在于这种患者群体中电风暴的预后影响.
研究的目的:
- 在接受ICD的患者中调查电风暴的预后意义.
- 为了比较经历电风暴的患者的结果与那些孤立的VT/VF发作患者的结果.
主要方法:
- 分析了457名患者的抗心律失常药与植入式除器 (AVID) 试验与ICDs.
- 电风暴定义为24小时内发生≥3次VT/VF事件.
- 使用依赖时间的考克斯建模进行生存分析,比较患有电风暴的患者,孤立的VT/VF和没有事件的患者.
主要成果:
- 电风暴发生在ICD植入后平均9.2个月,主要是VT (86%).
- 电风暴是随后死亡的重要独立预测因素 (RR 2.4,P=0.003).
- 在电风暴后的3个月内,死亡风险大幅增加 (RR 5.4,P<0.0001),随后降低.
结论:
- 电风暴是ICD患者死亡风险增加的关键独立标志物.
- 电风暴后的风险增加在前三个月最为明显.
- 不符合电风风暴标准的静脉动/心发作似乎没有增加死亡风险.
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