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植入心律转复除颤系统患者的死亡原因分析

Analysis of death causes in patients with implantable cardioverter defibrillator system

摘要:

目的 分析植入型心律转复除颤器(ICD)及心脏再同步除颤器(CRT-D)患者的死亡原因.方法 将2001年1月至2011年12月在浙江医院植入ICD及CRT-D的所有患者分为3组:ICD一级预防组,ICD二级预防组及CRT-D组.分析在随访过程中所有死亡患者的死亡原因.主要死亡原因设置为:心力衰竭死亡、其他心脏原因死亡、非心脏原因死亡、猝死及不知原因死亡.结果 共有289例患者植入ICD或CRT-D,ICD一级预防51例,二级预防107例,CRT-D 131例.平均随访(4.6±2.5)年,死亡54例,其中ICD一级预防有5例(9.8%)患者死亡,ICD二级预防20例(18.7%)患者死亡,CRT-D组29例(22.1%)患者死亡.10年累计所有原因病死率为18.7%.心力衰竭性死亡25例(46.3%),非心脏原因死亡19例(35.2%),有3例(5.6%)患者猝死.结论 在植入ICD或CRT-D的所有患者中,心力衰竭死亡及非心脏原因死亡是最常见的死亡原因.猝死在死亡患者中的比例较低.

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abstracts:

Objective To analyse the causes of death in patients with implantable cardioverterdefibrillator(ICD) and cardiac resynchronization therapy defibrillator(CRT-D).Methods From Jan.2001 to Dec.2011 all patients with ICD and CRT-D in Zhejiang hospital were included.All patients were divided into three groups:primary prevention ICD group,secondary prevention ICD group,and CRT-D group.Patients who died during follow-up period were retrieved.The causes of death included heart failure,other cardiac death,non-cardiac death,sudden death,and unknown cause of death.Results A total of 289 patients were included:51 primary prevention ICD,107 secondary prevention ICD,and 131CRTD.Average follow-up period was(4.6±2.5)years.Five patients (9.8%) with primary prevention ICD,20patients (18.7 %)with secondary prevention ICD,and 29 patients(22.1%)with CRT-D died.The 10-year cumulative incidence of all-cause mortality was 18.7%.There were 25 (46.3%) patients died from heart failure,19 (35.2%) non-cardiac reason,and 3 (5.6%) patients were sudden death.Conclusion Heart failure and non-cadiac death were the most common causes of death; incidence of sudden death was low.

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