Clinical Effects Of Icd In Patients With Malignant Ventricular Arrhythmia: A Pilot Study

Objective: To evaluate the efficacy of implantable cardioverter defibri- llator(ICD) in patients with malignant ventricular arrhythmia (MVA).Methods: Fiveteen MVA patients receieved ICD therapy from the First Affiliated Hospital of Guangxi Medical University were followed up by standard schedule . Data of patients' clinical conditions, of ICD relevant information, ECG, X-ray radio-graphy, and echocardiography were collected. And make a conclusion by analyzing above materials.Results: All patients had received ICD implantation successfully, which included 11 single-chamber ICDs, 2 dual-chamber ICDs and 1 three-chamber ICD. Patients were followed-up with a period of 18.53±9.26 months. No death during follow-up. Eight patients (53.3%) suffered from tachycardia events detected by ICD, with a total 89 episodes. Of these, 6 episodes were paroxysmal ventricular tachycardia (VT) and 54(60.7%) were sustained one. In sustained VT group 47(87%), episodes were terminated by ATP and 7(13%) episodes were terminated by low energy cardiovertion. There were 5 ventricular fibrillation (VF) episodes diagnosed by the devices, all of them were terminated by one-time shocks. Twenty-four episodes were supraventricular tachycardia (SVT), 8 of which were inappropriate diagnosed as VT/VF. The inappropriate rate is 11%. Three patients suffered from"electrical storm"(ES) and got serious anxiety because of frequent shock ICD. And the number of tachycardia episodes in above 8 tachycardia patients reduced significantly through setting appropriate parameters of ICD and increasing the dose of antiarrhythmic drugs.Conclusions: ICD with tiered therapy function is an effective treatment for terminating MVA. It is important to follow up the patients and set appropriate parameters of diagnosis and therapy . Meanwhile, taking antiarrhythmic drugs and providing psychological counseling is also important thing.