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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Clinical predictors and efficacy of antitachycardia pacing in patients with implantable cardioverter defibrillators: the importance of the patient's sex.
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Clinical predictors and efficacy of antitachycardia pacing in patients with implantable cardioverter defibrillators: the importance of the patient's sex.

机译：植入式心脏复律除颤器患者的抗心动过速起搏器的临床预测和疗效：患者性别的重要性。

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The ICD has become accepted as primary therapy for malignant ventricular arrhythmias. The incorporation of antitachycardia pacing into ICDs has provided a better tolerated alternative to shocks but has the potential disadvantage of delaying definitive therapy. Accordingly, we sought to delineate the characteristics of patients likely to experience unsuccessful termination of pacing and to identify ineffective pacing strategies. Of 519 patients who received ICDs, 11 clinical and tachycardia characteristics in the 162 who received antitachycardia pacing therapy for sustained ventricular arrhythmias were evaluated. Tachycardia episodes were grouped according to outcome of pacing (successful, unsuccessful, acceleration). Of 1,946 episodes, 1,502 (77.2%) were successfully reverted with pacing, 322 (16.5%) were unsuccessful, and 121 (6.2%) were accelerated. Antitachycardia pacing was less successful in women, patients with a history of myocardial infarction, those with more severe left ventricular dysfunction, those who received antiarrhythmic drugs, and those programmed to ramp pacing. Tachycardia acceleration was inversely related to tachycardia cycle length and was more frequent in patients programmed to more aggressive ramp pacing protocols. Women had an almost threefold incidence of tachycardia acceleration compared with men (14% vs 5%, P < 0.001). Antitachycardia pacing is generally successful in terminating ventricular tachycardia and has a low incidence of tachycardia acceleration. Caution should be used with rapid tachycardias and aggressive ramp pacing protocols because of an increased risk of acceleration. Antitachycardia pacing appears less successful and has a higher incidence of complications in women.
机译：ICD已被接受为恶性室性心律不齐的主要治疗方法。将抗心动过速起搏器整合到ICD中可提供更好的耐受性，可替代电击，但潜在的缺点是延迟最终治疗。因此，我们试图描述可能无法成功终止起搏的患者的特征，并确定无效的起搏策略。在接受ICD的519例患者中，对162例接受持续性心律失常的抗心动过速起搏治疗的患者的11种临床和心动过速特征进行了评估。心动过速发作根据起搏结果分组（成功，失败，加速）。在1,946次发作中，有1,502（77.2％）个通过起搏成功恢复，不成功322个（16.5％），加速了121个（6.2％）。在妇女，有心肌梗塞病史的患者，左心室功能不全较严重的患者，接受抗心律不齐药物的患者以及计划进行起搏的患者中，抗心动过速起搏效果较差。心动过速的加速与心动过速的周期长度成反比，并且在编程为更具攻击性的斜坡起搏方案的患者中更频繁。女性的心动过速加速发生率几乎是男性的三倍（14％比5％，P <0.001）。通常，抗心动过速起搏可成功终止室性心动过速，并且心动过速加速的发生率较低。对于快速的心动过速和积极的坡道起搏方案应谨慎使用，因为这会增加加速的风险。心动过速起搏似乎不太成功，女性并发症的发生率更高。

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