Efficacy and Limitations of Tachycardia Detection Interval Guided Reprogramming for Reduction of Inappropriate Shock in Implantable Cardioverter-Defibrillator Patients.
Efficacy and Limitations of Tachycardia Detection Interval Guided Reprogramming for Reduction of Inappropriate Shock in Implantable Cardioverter-Defibrillator Patients.
复制标题
心动过速检测间隔引导重新编程减少植入式心脏复律除颤器患者不适当电击的功效和局限性。
DOI：
10.1536/ihj.15-419
复制
发表时间：
2016
影响因子：
1.5
通讯作者：
J. Ako
中科院分区：
文献类型：
--
作者：
Tamami Fujiishi;S. Niwano;M. Murakami;Hironori Nakamura;T. Igarashi;N. Ishizue;J. Oikawa;J. Kishihara;H. Fukaya;H. Niwano;J. Ako
避免不当的电击治疗是植入型心律转复除颤器（ICD）患者的重要临床问题。我们回顾性分析了ICD患者的治疗事件，以及心动过速检测间期（TDI）和心动过速周期长度（TCL）指导的重新程控对减少不适当ICD治疗的影响。研究共纳入254例ICD患者，随访27.3 ± 18.7个月，评估抗心动过速治疗的发生率。当出现不适当的抗心动过速治疗时，TDI被重新编程为不超过检测到的TCL，患者继续随访。比较了ICD治疗不当和未使用不当患者的各种临床参数。在18.6 ± 15.6个月的初始随访期内，127/254例患者（50%）接受了ICD治疗，包括不适当的抗心动过速起搏（ATP）（12.9%）和休克（44.35%）。初始治疗不当的决定因素是扩张型心肌病（DCM）、治疗性低温史和QRS时限。在61例治疗不当的患者中，24例接受了TCL引导的重新程控。在17.0 ± 16.8个月的额外观察期内，5/24例患者（2例ATP，3例电击）再次出现不当治疗。重新程控后这些不适当治疗事件的决定因素是室上性心动过速的存在。通过应用简单的TCL和TDI引导的重新程控，不适当治疗减少了79%。重新程控后治疗不当的决定因素是室上性心动过速的存在。
The avoidance of inappropriate shock therapy is an important clinical issue in implantable cardioverter-defibrillator (ICD) patients. We retrospectively analyzed therapeutic events in ICD patients, and the effect of tachycardia detection interval (TDI) and tachycardia cycle length (TCL) guided reprograming on the reduction of inappropriate ICD therapy. The clinical determinants of after reprogramming were also evaluated.A total of 254 consecutive ICD patients were included in the study, and the incidence of antitachycardia therapy was evaluated during the follow-up period of 27.3 ± 18.7 months. When inappropriate antitachycardia therapy appeared, TDI was reprogrammed not to exceed the detected TCL and the patients continued to be followed-up. Various clinical parameters were compared between patients with and without inappropriate ICD therapy. During the initial follow-up period of 18.6 ± 15.6 months, ICD therapy occurred in 127/254 patients (50%) including inappropriate antitachycardia pacing (ATP) (12.9%) and shock (44.35%). Determinants of initial inappropriate therapy were dilated cardiomyopathy (DCM), history of therapeutic hypothermia, and QRS duration. Of the 61 patients with inappropriate therapy, 24 received TCL guided reprogramming. During the additional observation period of 17.0 ± 16.8 months, inappropriate therapy recurred in 5/24 patients (2 ATP, 3 shocks). The determinant of these inappropriate therapy events after reprogramming was the presence of supraventricular tachycardia.By applying simple TCL and TDI guided reprogramming, inappropriate therapy was reduced by 79%. The determinant of inappropriate therapy after reprogramming was the presence of supraventricular tachycardia.
对从近乎致命的室性心律失常中复苏的患者进行抗心律失常药物治疗与植入式除颤器的比较。
DOI：
10.1056/nejm199711273372202
发表时间：
1997
期刊：
The New England journal of medicine
影响因子：
--
作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
通讯作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
影响因子：
158.5
作者：
Bardy, GH;Lee, KL;Ip, JH
通讯作者：
Ip, JH