Appropriate and inappropriate electrical therapies delivered by an implantable cardioverter-defibrillator: effect on intracardiac electrogram.
Appropriate and inappropriate electrical therapies delivered by an implantable cardioverter-defibrillator: effect on intracardiac electrogram.
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由植入式心脏逆转表纤维传递的适当且不适当的电疗法：对心脏内电图的影响。
DOI：
10.1111/j.1540-8167.2010.01958.x
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发表时间：
2011-05
影响因子：
2.7
通讯作者：
Tereshchenko LG
中科院分区：
文献类型：
--
作者：
Stempniewicz P;Cheng A;Connolly A;Wang XY;Calkins H;Tomaselli GF;Berger RD;Tereshchenko LG
诱导室颤抢救ICD电击后观察到的局部损伤电流（LIC）可预测心力衰竭进展。我们试图确定接受ICD治疗的患者自发事件后LIC的频率。在134例患者（平均年龄60.8±14.8，106例[79%]男性）中发生的420起事件中，将ICD治疗后10秒内的近场（NF）右心室（RV）EGM与基线EGM进行比较。快速电描记图主要偏转后即刻电位升高或降低的幅度定义为LIC，其与电描记图峰-峰幅度的比值定义为相对LIC。LIC至少为1 mV或相对LIC至少为15%被认为是显著的。在121起事件中观察到LIC（28.8%），并且在适当的（43例[60.6%]事件）和不适当（56例[64.4%]事件）ICD电击，与适当的（8例[9.2%]事件）和不适当（3例[4.7%]事件）抗心动过速起搏（ATP）或非持续性室性心动过速（11例[9.9%]事件）[ANOVA p<0.0001]。ICD治疗类型（ICD电击与ATP）是LIC最重要的预测因素（ATP β系数−0.81; 95%CI-1.19 -−0.44）; P<0.0001），沿着心动过速周期长度（β系数−0.0117; 95%CI-0.0167 - −0.0068，P<0.00001）和冲击能量（β系数0.024; 95%CI 0.003 - 0.045，P=0.025）。适当和不适当的ICD电击通常以结构性心脏病患者发生LIC为特征。电ICD治疗类型、电击能量和室性心律失常周期长度是LIC的重要决定因素。
Local injury current (LIC) seen after induced ventricular fibrillation rescue ICD shock predicts heart failure progression. We sought to determine the frequency of LIC after spontaneous events in patients receiving ICD therapies. Near-field (NF) right ventricular (RV) EGM during 10 sec after delivered ICD therapy was compared with baseline EGM in 420 events that occurred in 134 patients (mean age 60.8±14.8, 106 [79%] male). The magnitude of elevated or depressed potential immediately after the major fast EGM deflection was defined as LIC, and its ratio to the peak-to-peak EGM amplitude was defined as relative LIC. LIC of at least 1 mV or relative LIC of at least 15% was considered significant. LIC was observed in 121 events (28.8%) and was detected more frequently after appropriate (43 [60.6%] events) and inappropriate (56 [64.4%] events) ICD shocks, as compared with appropriate (8 [9.2%] events) and inappropriate (3 [4.7%] events) antitachycardia pacing (ATP) or nonsustained ventricular tachycardia (11 [9.9%] events) [ANOVA p<0.0001]. Type of ICD therapy (ICD shock vs. ATP) was the most significant predictor of LIC (ATP β coefficient −0.81; 95%CI-1.19 –−0.44); P<0.0001), along with cycle length of tachycardia (β coefficient −0.0117; 95%CI-0.0167 – −0.0068, P<0.00001) and shock energy (β coefficient 0.024; 95%CI 0.003 – 0.045, P=0.025). Appropriate and inappropriate ICD shocks are frequently characterized by the development of LIC in patients with structural heart disease. Type of electrical ICD therapy, shock energy and cycle length of ventricular arrhythmia are important determinants of LIC.
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DOI：
10.1056/nejmoa071098
发表时间：
2008-09-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Poole JE;Johnson GW;Hellkamp AS;Anderson J;Callans DJ;Raitt MH;Reddy RK;Marchlinski FE;Yee R;Guarnieri T;Talajic M;Wilber DJ;Fishbein DP;Packer DL;Mark DB;Lee KL;Bardy GH
通讯作者：
Bardy GH
影响因子：
6.1
作者：
Duray, Gabor Z.;Schmitt, Joern;Hohnloser, Stefan H.
通讯作者：
Hohnloser, Stefan H.
影响因子：
37.8
作者：
Thibault, Helene;Piot, Christophe;Ovize, Michel
通讯作者：
Ovize, Michel
影响因子：
4.2
作者：
Wang, Norman C.;Piccini, Jonathan P.;Gheorghiade, Mihai
通讯作者：
Gheorghiade, Mihai
影响因子：
158.5
作者：
Moss, AJ;Hall, WJ;Heo, M
通讯作者：
Heo, M