Automatic implantable cardioverter defibrillators and survival of patients with left ventricular dysfunction and malignant ventricular arrhythmias.
Automatic implantable cardioverter defibrillators and survival of patients with left ventricular dysfunction and malignant ventricular arrhythmias.
复制标题
自动植入式心脏复律除颤器与左心室功能障碍和恶性室性心律失常患者的生存。
DOI：
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复制
发表时间：
1988
影响因子：
39.2
通讯作者：
Masood Akhtar
中科院分区：
文献类型：
--
作者：
P. Tchou;N. Kadri;Jerry Anderson;J. Caceres;M. Jazayeri;Masood Akhtar
研究目的
评估恶性室性心律失常和左心室功能不全高危患者植入自动植入式心律转复器后的生存率。
设计
单组患者的实际生存时间与无疟疾时间的比较。
设置
三级转诊中心的住院服务和门诊随访。
患者
连续70名患有临床持续性室性心动过速或心室颤动的患者，根据编程电刺激确定，心律失常无法通过药物控制，并且植入了自动心律转复除颤器。
干预
所有患者均接受了植入式除颤器。
测量值和主要结果
2年生存率为93.4%（95%CI，87 - 99.8），基于恶性心律失常复发的预测生存率为60.3%（CI，47.3 - 73.3; P <0.001）。在25例左室射血分数小于30%的患者中，实际生存率为86.7%（CI，72.3至91.1），预计生存率为56.9%（CI，35.9至77.9; P = 0.025）。预计的生存率与文献中报道的高风险患者的生存率相似。只有1例猝死;其余的死亡都不是自杀性的。在随访结束时存活的65例患者中，13例为纽约心脏协会I级; 44例为II级; 5例为III级; 3例为IV级。
结论
自动植入式心律转复除颤器可能是非常有效的，即使在高风险患者预防心脏病死亡。这种治疗似乎不会显著损害患者的功能状态。
STUDY OBJECTIVE
To assess survival after insertion of automatic implantable cardioverter defibrillators in high-risk patients who have malignant ventricular arrhythmias and left ventricular dysfunction.
DESIGN
Actual survival time compared with arrhythmia-free time in a single group of patients.
SETTING
Inpatient services of a tertiary referral center and outpatient follow-up.
PATIENTS
Seventy consecutive patients with clinical sustained ventricular tachycardia or fibrillation whose arrhythmia could not be controlled by medication as determined by programmed electrical stimulation, and who had an automatic cardioverter defibrillator implanted.
INTERVENTION
All patients received an implantable defibrillator.
MEASUREMENTS AND MAIN RESULTS
Two-year survival was 93.4% (95% CI, 87 to 99.8) and projected survival based on recurrence of malignant arrhythmias was 60.3% (CI, 47.3 to 73.3; P less than 0.001). In the 25 patients with left ventricular ejection fraction less than 30%, actual survival was 86.7% (CI, 72.3 to 91.1) and projected survival was 56.9% (CI, 35.9 to 77.9; P = 0.025). Projected survival percentages are similar to survival figures reported in the literature for such high-risk patients. There was only one sudden death; the remaining deaths were not arrhythmic in nature. Of the 65 patients who were alive at the end of follow-up, 13 were in New York Heart Association Class I; 44, Class II; 5, Class III; and 3, Class IV.
CONCLUSIONS
The automatic implantable cardioverter defibrillator is probably highly effective in preventing arrhythmic mortality even in high-risk patients. Such treatment does not appear to significantly impair a patient's functional status.
植入自动除颤器的患者的死亡率。
影响因子：
39.2
作者：
Mirowski,M;Reid,PR;Winkle,RA;Mower,MM;WatkinsJr,L;Stinson,EB;Griffith,LS;Kallman,CH;Weisfeldt,ML
通讯作者：
Weisfeldt,ML
通过动态监测对室性心动过速和室颤幸存者进行预后评估。
DOI：
10.1016/0002-9149(84)90309-6
发表时间：
1984
期刊：
The American journal of cardiology
影响因子：
--
作者：
Vlay,SC;Kallman,CH;Reid,PR
通讯作者：
Reid,PR