The Cause Analysis and Countermeasures of Frequent Shocks in Patients with Implantable Cardioverter Defibrillator
10.3969/j.issn.0253-9896.2014.03.021
- VernacularTitle:埋藏式心脏除颤器患者频繁电击原因分析及对策
- Author:
Dongyan WU
;
Cainai XING
;
Fengmin LU
;
Naikuan FU
;
Jing XU
- Publication Type:Journal Article
- Keywords:
cardiovascular diseases;
defibrillators,implantable;
arrhythmias,cardiac;
death,sudden;
electroshock;
implantable cardioverter defibrillator;
frequent shock;
secondary prevention;
electric shock treatment
- From:
Tianjin Medical Journal
2014;(3):260-263
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.
