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经静脉植入心律转复除颤器联合药物治疗恶性心律失常的临床分析 杨成彬 【摘要】目的：观察应用植入型心律转复除颤器（Implantable Cardioverter Defibrillators ,ICD）联合抗心律失常药物治疗恶性心律失常的疗效。方法：72岁男患，诊断为高血压病，左室舒张功能不全，短阵室速。反复发生晕厥，24小时动态心电图为室速发作，药物疗效不佳.经静脉单根电极导线植入右心室心尖部，ICD放置于左胸部皮下囊袋内下。除颤电流由右心室心内线圈状电极至除颤器电极外壳本身。术后予以补钾，胺碘酮、倍他乐克抗心律失常治疗。结果：随访22月，共发生室速，室颤15次，一次经ICD抗心动过速起搏(antitachycardia pacing , ATP)终止，其余均经过ICD除颤终止，无晕厥发生。结论：ICD能有效转复恶性心律失常，植入方法较简单，值得推广。术后予以胺碘酮、倍他乐克，纠正电解质紊乱可以减少室速、室颤的发生，减少ICD放电，延长ICD的寿命。 【关键词】除颤器 药物 心律失常 The Clinical Analysis of Implantable Cardioverter Defibrillators and antiarrhythmic drugs in Patients with Malignant Arrhythmia. 【abstract】 objective: to observe therapeutic effect of Implantable Cardioverter Defibrillators and Antiarrhythmic Drugs to Malignant Arrhythmia.. method:72 years old male patient , diagnosis is hypertensive disease、left ventricle diastolic function defect 、nonsustained ventricular tachycardia（NSVT）.occurrence apopsychia repeatly . 24 hours Holter monitoring electrocardiogram reveal it was ventricular tachycardia .and Antiarrhythmic Drugs therapy was unsuccessful to him. Implant single electrode cable to Apex of right ventricle through vein。ICD was imlpanted in left chest subcutaneous pocket .electric current of defibrillation from circularity electrode inter right ventricle to defibrillator electrode outer shell itself, administer kalium chloratum，amiodarone ，β- receptor blocking pharmacon for anti-arrhythmia therapy after operation. Result：follow-up visited 22 months，occurrence 15 ventricular tachycardias in all ，one of them was terminated by antitachycardia pacing, others was terminated by defibrillation through ICD. Apopsychia was disappeared . Conclusion：ICD can convert malignant arrhythmia effectively.the method of implantation is simple, it’s worthy to generalize. ventricular tachycardia、ventricular fibrillation can be reduced by administration of amiodarone，β- receptor blocking pharmacon and correcting electrolyte disturbances to reduce electric discharge o