Comparative analysis the efficacy of different types of cardioverter defibrillator in patients with high risk of sud den cardai c death

JIAO Fengjun; LI Huan; REN Xuai; SHI Daw ei; CUI Tao

doi:10.3969/j.issn.1671-6450.2015.11.002

Abstract：Objective To investigate the curative effect of implantable cardiac defibrillator (ICD),cardioverter re-synchronization therapy( CRT) and ventricular resynchronization therapy with defibrillators ( CRT-D) in the cardiogenic sud-den death high-risk patients.Methods Selected from 2006 January to 2014 December, 92cases of cardiogenic sudden death high-risk patients, 42 cases of patients with the ICD implantation (ICD group), 43 cases of patients implanted with a CRT ( CRT group) , 7 cases of patients with CRT-D implantation ( CRT-D group) , to observe different groups of patients'operation, operation time, X-ray exposure time and postoperative cardiovascular events, left ventricular ejection fraction( LVEF) , left ventricular diastolic end diastolic diameter (LVEDD), 6 minutes walk distance (6MWT) and fatality rate etc.Results ICD group operation success rate was 100%, in the CRT group success rate was 93.0%, CRT-D group success rate was 100%, 3 groups'surgery success rate's differences were not statistically significant ( P >0.05).ICD group's operation time and fluoros-copy time were (2.02 ±0.89) h and (8.32 ±2.62) min respectively,significantly shorter than tin the CRT group(3.04 h ± 1.2 h, 43.10 min ±6.73 min) and CRT-D group (3.71 h ±1.21 h, 35.21 min ±761 min), the difference were statistically significant ( P <0.05); difference between the CRT-D and CRT group's operation time showed no statistical significance ( P >0.05);CRT-D group's X-ray exposure time was shorter than the CRT group, the difference was statistically significant ( P <0.05) .ICD group before and after surgery, patients'LVEF, LVEDD had no obvious changes, 6MWT have significantly improvement ( P <0.05);patients in the CRT group 1 month LVEF was obviously improved,after 6 months, 6MWT have significantly improved, postoperative 1 year's LVEDD improvement was statistically significant ( P <0.05);CRT-D group's LVEF,6MWT have significantly improvement( P <0.05)a,nd LVEDD before and after surgery showed no significant changes ( P >0.05).CRT-D group had no patients died, the ICD group mortality rate was 11.9% (5/42), CRT group's mortality rate was 16.3% (7/43), 3 groups'mortality rate difference were not statistically significant ( P >0.05).Conclusion ICD, CRT and CRT-D had obvious protective effects for patients with sudden death high-risk, and 3 kinds of treatment as ICD, CRT and CRT-D should be reasonable chose for patients in order to obtain the best potency ratio.