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Clinical characteristics of patients with an implantable cardioverter-defibrillator: Our experience at Asan Medical Center
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È«À±±â(Hong Yoon-Ki) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ½ÉÀå³»°úÇб³½Ç
¹Ú°æ¹Î(Park Kyoung-Min) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ¼¿ï¾Æ»êº´¿ø ½ÉÀå³»°ú
±èÁ¤¿í(Kim Jung-Wook) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÇü¿ë(Kim Hyung-Yong) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ¼¿ï¾Æ»êº´¿ø
±èÀ¯È£(Kim Yoo-Ho) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ½ÉÀå³»°úÇб³½Ç
³²±âº´(Nam Gi-Byoung) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ½ÉÀå³»°úÇб³½Ç
ÃÖ±âÁØ(Choi Kee-Joon) - ¿ï»ê´ëÇб³ ÀÇ°ú´ëÇÐ ½ÉÀå³»°úÇб³½Ç
Abstract
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°á °ú : Á¦¼¼µ¿±â¸¦ »ðÀÔÇÏ°Ô µÈ ȯÀÚµéÀÇ 3°¡Áö ÁÖ¿ä ±âÀú ÁúȯÀº ½É±Ù °æ»ö ÈÄ ½É½Ç¼º ºó¸Æ, ºê·ç°¡´Ù ÁõÈıº, ºñÈļº ½É±ÙÁõÀ̾ú°í, ÀÌ Áß ºê·ç°¡´Ù ÁõÈıºÀÌ »ó´ëÀûÀ¸·Î ¸¹Àº °ÍÀº ¼±¸¿Í ´Ù¸¥ Ư¡ÀÌ´Ù. Á¦¼¼µ¿±â »ðÀÔ ÈÄ ÀûÀýÇÑ Àü±â Ãæ°ÝÀÌ 43¸í(31.9%)¿¡¼ ¹ß»ýÇÏ¿´À¸¸ç, ºÎÀûÀýÇÑ Àü±âÃæ°Ýµµ 39¸í(28.9%)¿¡¼ ¹ß»ýÇÏ¿´´Ù.
°á ·Ð : Á¦¼¼µ¿±â´Â ±Þ¼º ½ÉÀå»çÀÇ °íÀ§Ç豺 ȯÀÚ¿¡¼ Ä¡¸íÀûÀÎ ½É½Ç¼º ºÎÁ¤¸ÆÀ¸·Î ÀÎÇÑ »ç¸ÁÀ» °¨¼Ò½ÃÅ°´Âµ¥ Áß¿äÇÑ ¿ªÇÒÀ» ÇÒ °ÍÀ¸·Î »ý°¢µÈ´Ù. ÇÏÁö¸¸ »ó´ç¼öÀÇ È¯ÀÚ¿¡¼ ºÎÀûÀýÇÑ Àü±âÃæ°ÝÀ̳ª Á¦¼¼µ¿±âÀÇ °¨Áö¿À·ù µîÀÇ ¹®Á¦°¡ ¹ß»ýÇÏ¿´°í, ÀÌ´Â ÀûÀýÇÑ Ç׺ÎÁ¤¸ÆÁ¦ÀÇ »ç¿ëÀ̳ª Á¦¼¼µ¿±â °¨Áö ¼³Á¤ÀÇ ÃÖÀûÈ µîÀ» ÅëÇÏ¿© ÃÖ¼ÒÈÇÒ Çʿ伺ÀÌ ÀÖÀ½À» ½Ã»çÇÑ´Ù.
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¡¾13 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¡¾2.0 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.
Conclusion : 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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Implantable cardioverter defibrillator, Sudden cardiac death
KMID :
0882420080740010068
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À¯È¿¼º°á°ú(Recomendation)
The three major cardiovascular diseases in patients with ICD implantation were post?MI VT, Brugada syndrome and hypertrophic CM.