Study On Influence Factors Of Prognosis In Patients With Implantable Cardioverter Defibrillator

Objective:To analyze the clinical factors influencing the prognosis of patients with implantable cardioverter defibrillator(ICD).Methods:we retrospectively analyzed all clinical data of ICD and cardiac resynchronization pacemaker-defibrillator(CRTD)implantation patients from December 2014 to December 2018 in Shanxi Cardiovascular Hospital.The patients occurred postoperative ventricular arrhythmia(ventricular tachycardia/ventricular fibrillation)were assigned to group A1,otherwise to group A2.The patients occurred Postoperative clinical events(death/rehospitalization)were assigned to group B1,otherwise to group B2.We analyzed risk factors of postoperative ventricular arrhythmia(ventricular tachycardia/ventricular fibrillation)events and clinical events(death/rehospitalization),and further the survival analysis and COX regression analysis of multiple factors were done.Results:A total number of 87 patients were enrolled.The median follow-up was 28.4 months.There were 44 patients(50.5%)in group A1 after surgery,23(26.4%)received appropriate electric shocks of these,and 8 of the 43 patients(9.2%)received false electric shocks In group A2.Fifty patients were included in group B1 with clinical events,and the total mortality/rehospitalization rate was 51.7% at 1 year of follow-up.Survival analysis showed that patients with preoperative QT interval dispersion(QTd)≥80ms had higher rate of postoperative ventricular arrhythmia(P< 0.001)and higher rate of clinical events(P=0.001)compared with patients who had preoperative QT interval dispersion(QTd)< 80 ms.Multivariate analysis showed that the Preoperative QTd≥80ms was a risk factor for postoperative ventricular arrhythmia(HR=7.575,95%CI=2.529～22.687,P<0.001)and death/rehospitalization(HR=3.218,95%CI=1.285～8.061,P=0.013),amiodarone(HR=0.320,95%CI=0.126～0.812,P=0.016)can reduce the occurrence of postoperative ventricular arrhythmia.Conclusion:Preoperative QTd ≥ 80 ms is a risk factor for postoperative ventricular arrhythmia and death/rehospitalization in patients who had implanted ICD/CRTD,while the use of amiodarone can effectively reduce the incidence of ventricular arrhythmia.