【摘要】 目的观察埋藏式心脏复律除颤器(implanted cardioverter-defibrillators,ICD)在治疗Brugada综合征中的作用。方法对2005年1月至2009年12月在广东省人民医院确诊Brugada综合征的11例患者植入ICD后的临床资料进行回顾性分析。结果植入ICD进行一级预防的患者4例(36.36%),临床表现为持续性室性心动过速或心室颤动的二级预防的患者7例(63.64%)。起搏模式:6例(54.55%)单腔ICD,5例(45.45%)双腔ICD。所有患者术中测试ICD的起搏参数并诱发心室颤动,采用20 J一次电击复律成功。随访(17.0±12.7)个月,无漏访。一级预防组和二级预防组发生恶性室性心律失常的患者分别为2例和3例;两组室性心动过速发作阵次比例[80%(4/5)vs.90.3%(28/31),P>0.05]和心室颤动发作阵次比例[20%(1/5)vs.9.6%(3/31),P>0.05]比较,差异无统计学意义;两组抗心动过速起搏成功率[75%(3/4)vs.96%(24/25),P>0.05]及除颤治疗成功率[100%(2/2)vs.100%(4/4),P>0.05]比较,差异无统计学意义。术中及术后未见植入ICD相关并发症。结论对Brugada综合征患者植入ICD预防心脏性猝死是安全有效的。更多还原

【Abstract】 Objectives To evaluate the clinic effect of implanted cardioverter-defibrillators(ICD) in patients with Brugada syndrome.Methods Eleven patients with Brugada syndrome had successfully been implanted ICD in Guangdong General Hospital from January 2005 to December 2009.All Patients were followed up regularly.The data were reviewed retrospectively.Results In these patients,there were 4 patients(36.36%) for primary prevention and 7 patients(63.64%) with incessant tachycardia or ventricular fibrillation for secondary prevention.A total of 11 episodes of ventricular flutter were induced at ICD implantation [single chamber 6,dual chamber 5(45.45%)] and defibrillation threshold was 20 J.Eleven patients were followed up for(17.0±12.7) months.There were 2 patients with malignant ventricular arrhythmia in primary prevention group and 3 patients in secondary prevention group;neither in proportion of attacks of ventricular tachycardia [80%(4/5) vs.90.3%(28/31),P>0.05] nor ventricular fibrillation [20%(1/5) vs.9.6%(3/31),P>0.05].Achievement ratios of antitachycardia pacing [75%(3/4) vs.96%(24/25),P>0.05] and defibrillation [100%(2/2) vs.100%(4/4),P>0.05] between primary prevention group and secondary prevention group had no significant differences.No ICD-related complications were shown during operation or after operation.Conclusions Implantation of ICD is a safe and effective approach to treat Brugada syndrome and prevent sudden cardiac death.更多还原