삽입형 심실제세동기를 삽입한 환자들의 임상적 특징
Clinical characteristics of patients with an implantable cardioverter-defibrillator: Our experience at Asan Medical Center
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Background/Aims : The purpose of this study was to analyze the clinical features of the patients who underwent implantable cardioverter- defibrillator (ICD) treatment. Methods : The clinical features and the test data of the intracardiac electrograms for the patients who underwent ICD implantation between 1996 and 2005 at Asan Medical Center were retrospectively analyzed. Results : One hundred thirty five patients (109 males and 26 females, a mean age of 54±13 years) were included in this study. The underlying cardiovascular diseases were post-myocardial infarction (MI) ventricular tachycardia (VT), Brugada syndrome, hypertrophic cardiomyopathy (CM) and dilated CM. During a mean of 2.9±2.0 years of follow-up, appropriate shocks were delivered in 43 (31.9%) and inappropriate shocks were delivered in 39 (28.9%) patients. Anti-tachycardia pacing therapy was effective in 17 patients. Inappropriate shocks were caused by atrial fibrillation with rapid ventricular responses, T wave oversensing or electromagnetic interference. Major complications of ICD therapy during follow-up included ICD infection, lead problems, electromagnetic interference and generator malfunction. Conclusions : The three major cardiovascular diseases in patients with ICD implantation were post‐MI VT, Brugada syndrome and hypertrophic CM. Inappropriate shocks were delivered to a significant proportion of the patients, which emphasize the need for an aggressive rate control strategy in patients with atrial fibrillation. Most complications of ICD therapy were caused by device malfunction. (Korean J Med 74:68-74, 2008)
Abstract
Background/Aims : The purpose of this study was to analyze the clinical features of the patients who underwent implantable cardioverter- defibrillator (ICD) treatment. Methods : The clinical features and the test data of the intracardiac electrograms for the patients who underwent ICD implantation between 1996 and 2005 at Asan Medical Center were retrospectively analyzed. Results : One hundred thirty five patients (109 males and 26 females, a mean age of 54±13 years) were included in this study. The underlying cardiovascular diseases were post-myocardial infarction (MI) ventricular tachycardia (VT), Brugada syndrome, hypertrophic cardiomyopathy (CM) and dilated CM. During a mean of 2.9±2.0 years of follow-up, appropriate shocks were delivered in 43 (31.9%) and inappropriate shocks were delivered in 39 (28.9%) patients. Anti-tachycardia pacing therapy was effective in 17 patients. Inappropriate shocks were caused by atrial fibrillation with rapid ventricular responses, T wave oversensing or electromagnetic interference. Major complications of ICD therapy during follow-up included ICD infection, lead problems, electromagnetic interference and generator malfunction. Conclusions : The three major cardiovascular diseases in patients with ICD implantation were post‐MI VT, Brugada syndrome and hypertrophic CM. Inappropriate shocks were delivered to a significant proportion of the patients, which emphasize the need for an aggressive rate control strategy in patients with atrial fibrillation. Most complications of ICD therapy were caused by device malfunction. (Korean J Med 74:68-74, 2008)
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