Effect of substance abuse on defibrillation threshold in patients with implantable cardioverter-defibrillator.
Effect of substance abuse on defibrillation threshold in patients with implantable cardioverter-defibrillator.
复制标题
药物滥用对植入式心律转复除颤器患者除颤阈值的影响。
DOI：
10.1111/j.1540-8159.2010.02907.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Jacob,Sony
中科院分区：
文献类型：
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作者：
Perrine,ShaneA;Nayak,Raghavendra;Bharadwaj,AdityaS;McKelvey,George;Mohamad,Tamam;Jacob,Sony
背景：娱乐性药物的使用已被观察到对心脏有有害的影响。本研究的目的是评估药物滥用对植入式心律转复除颤器（ICDs）患者除颤阈值（DFT）的影响。方法：回顾性分析在密歇根州底特律市某高等大学医学中心接受ICD安置的患者。根据自我报告的药物使用情况确定受试者，并将其分为三组：对照组、可卡因组和其他非法药物组。由于组间种族差异，DFT值的主要分析仅针对非裔美国患者。此外，探索性分析了大麻使用和种族对DFT值的影响。结果：可卡因使用史（n = 17）显著增加非裔美国人DFT(17.3±8焦耳[J] vs 12.5±5焦耳，P < 0.05)，而既往使用大麻对DFT无显著影响。有非法药物使用史的非裔美国患者在较早年龄和对照组（非药物使用组）有ICD植入指征；非裔美国人（n = 73）的DFT高于白种人（n = 32）（14.5±0.5 J vs 9.7±0.6 J, P < 0.05）。结论：患有ICD的非裔美国人有可卡因使用史是高DFT的危险因素，种族本身（非裔美国人）可能是高DFT的危险因素。对于曾经使用或继续使用可卡因或在植入时不能进行DFT测试的患者，可以考虑使用高能icd和其他降低DFT的技术。（pace 2011; 34:19 93 - 199）
Background:The use of recreational drugs has been observed to have deleterious effects on the heart. The aim of our study was to evaluate the effect of substance abuse on the defibrillation threshold (DFT) in patients with implantable cardioverter‐defibrillators (ICDs).Methods:A retrospective analysis was conducted on patients who had undergone ICD placement at a tertiary university medical center in Detroit, Michigan. Subjects were identified based on self‐reported drug use and placed into one of the three groups: controls, cocaine, and other illicit drugs. Due to a disparity in race among groups, the main analysis on DFT value was conducted on African‐American patients only. Furthermore, exploratory analyses were conducted to investigate the effects of marijuana use and race on DFT values.Results:A history of cocaine use (n = 17) significantly increases DFT among African Americans (17.3 ± 8 Joule [J] vs 12.5 ± 5 J in cases vs controls, P < 0.05), while previous use of marijuana does not significantly influence DFT. African‐American patients with a history of illicit drug use had indications for ICD implantation at an earlier age and that within the control (nondrug using) group; African Americans (n = 73) had higher DFT compared to Caucasians (n = 32), (14.5 ± 0.5 J vs 9.7 ± 0.6 J, P < 0.05).Conclusions:A history of cocaine use in African Americans with ICD is a risk factor for high DFT and race itself (being African American) may be a risk for high DFT. Use of high‐energy ICDs and other DFT lowering techniques may be considered for patients who have used or continue to use cocaine or in whom DFT testing cannot be performed at the time of implantation. (PACE 2011; 34:193–199)