植入式心脏转换器-除器在Fallot的四分之一
Paul Khairy1, Louise Harris, Michael J Landzberg
1Adult Congenital Heart Center, Montreal Heart Institute, 5000 Bélanger St, Montreal, Quebec, Canada H1T 1C8. paul.khairy@umontreal.ca
Circulation
|January 4, 2008
概括
在Fallot患者的四重症中,植入式心脏转换器-除器 (ICD) 提供了有效的冲击疗法,但存在风险. 高比例的适当冲击和并发症需要对这些先天性心脏病患者进行仔细考虑.
科学领域:
- 心脏病学 心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 电子生理学 电子生理学
背景情况:
- 费洛特四病是接收可植入心脏转换器-除器 (ICD) 的患者中最常见的先天性心脏病.
- 关于ICD在这种特定高风险人群中的有效性和安全性的数据有限.
研究的目的:
- 为了评估ICD在患有Fallot四重律的患者中的有效性.
- 为了确定适当的ICD排放的风险因素.
- 描述与ICD相关的并发症和死亡率.
主要方法:
- 一项多中心队列研究,涉及121名高风险的患有Fallot四重律的患者.
- 患者接受了ICDs作为突发心脏死亡的初级或二级预防.
- 随访持续时间的中位数为3.7年,评估ICD出院和并发症.
主要成果:
- 30.6%的患者获得了适当的ICD出院,二次预防的比例更高.
- 在初级预防中,适当的冲击的独立预测因素包括左心室末端透气压升高和非持续性心室低心率.
- 每年有5.8%的患者发生不适当的冲击,有29.8%的患者出现并发症,主要是与晚期有关的问题.
结论:
- 接受ICD的Fallot四重症患者在心室失常症中经历了相当高的适当冲击率.
- 不适当的冲击和晚期相关并发症的高发病率是令人担忧的.
- 每年死亡率为2.2%,初级和二级预防组之间没有显著差异.
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