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首页> 外文期刊>Circulation journal >Upper limit of vulnerability during defibrillator implantations predicts the occurrence of appropriate shock therapy for ventricular fibrillation
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Upper limit of vulnerability during defibrillator implantations predicts the occurrence of appropriate shock therapy for ventricular fibrillation

机译：除颤器植入过程中的易损性上限预测发生适当的电击疗法以治疗心室纤颤

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Background: The utility of the upper limit of vulnerability (ULV) test in patients undergoing defibrillator implantation has been reported, so the purpose of this study was to evaluate the difference in the clinical outcomes between patients with ULV ≤15 J or >15 J. Methods and Results: A total of 165 patients receiving an implantable cardioverter-defibrillator underwent a vulnerability test. At the time of the implantation, we delivered a 15-J shock on the T-peak and ±20 ms later to cover the most vulnerable part of the cardiac cycle. The clinical outcomes were prospectively analyzed. A 15-J shock induced ventricular fibrillation (VF) in 30 patients (ULV >15 J) and did not in 135 (ULV ≤15 J). The characteristics of the 2 groups were comparable. After a mean follow-up of 757 days, Kaplan-Meier curve analysis showed that the ULV ≤15 J group experienced less VF than the ULV >15 J group (log-rank P=0.003). The occurrence of ventricular tachycardia was similar between the 2 groups (P=0.140). Furthermore, the effectiveness of ATP was comparable. After adjusting for other known predictors of shock therapy, a ULV >15 J was independently associated with the occurrence of VF (hazard ratio: 6.25; 95% confidence interval: 1.913-20.40; P<0.01). Conclusions: A high ULV value was associated with a high incidence of VF, which suggests that cardiac vulnerability to electrical shock may be linked to electrical instability.
机译：背景：已经报道了对除颤器植入患者进行脆弱性上限（ULV）测试的实用性，因此本研究的目的是评估ULV≤15J或> 15 J的患者之间临床结局的差异。方法和结果：共有165名接受植入式心脏复律除颤器的患者接受了脆弱性测试。植入时，我们在T峰上施加了15-J的电击，并在±20 ms之后进行了电击，以覆盖心动周期中最脆弱的部分。对临床结果进行前瞻性分析。 15-J休克诱发的心室纤颤（VF）在30例患者中（ULV> 15 J），而在135例中未发生（ULV≤15J）。两组的特征具有可比性。平均随访757天后，Kaplan-Meier曲线分析显示，ULV≤15J组的VF低于ULV> 15 J组（log-rank P = 0.003）。两组之间室性心动过速的发生率相似（P = 0.140）。此外，ATP的有效性是可比的。在调整其他已知的电击疗法预测因素后，ULV> 15 J与VF的发生独立相关（危险比：6.25; 95％置信区间：1.913-20.40; P <0.01）。结论：高ULV值与VF的高发生率相关，这表明心脏对电击的脆弱性可能与电的不稳定有关。

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