Summary:
The aim of this work is to characterize and analyse the spectrum of therapies delivered from
implantable cardioverter-defibrillators (ICD), to evaluate their effectivity and to mark the most
effective types of antitachycardia stimulations (ATP), cardioversion (CV) and defibrillation (CD).
To compare our results with references and give precautions of troubleshootings.
Our patients had implanted ICDs according to standard criteria for ICD implantations. Before
discharge from hospital we performed predischarge test of their ICD. Than we followed them
periodically each three months. We have observed 72 ICD pts (55 M, 17 F) in the mean age of 62,7 ±
12,2 years the with mean LVEF was 0.37 ± 0.11. The mean follow-up was 21 ± 12,8 months. Each
examination was managed through anamnesis of symptoms accompanying the beginning of arrythmia, the sensation of ICD therapy by patient, followed by interrogation of the ICD memory.
All obtained episodes were analysed.
During the follow-up 1023 episodes of malignant ventricular arrhythmias were detected and
effectively terminated. 7 pts died. During the therapy the ATP reached 83 % in comparison with
CV, CD which reached only 17 %. The dominating symptoms were palpitations and presyncopes.
In comparison with initial arrhythmias leading to implantations of ICDs (ventricular fibrillations
for most of the cases - 54 %) the significantly higher number of spontaneous episodes were caused
by monomorphic ventricular tachycardias VT (92.0 %). We had no sudden cardiac death in our pts.
In the indicated pts with a high risk of sudden arrhytmic death, the ICD therapy is characterized
as very effective and is associated with high safety, low discomfort and when up to date algorithms for detection being used, then only adequate part of the innappropriate therapies occurs
(10 % patients, 3. 2 % from the number of episodes).
The therapy by implantable cardioverterefibrillators has had an important role in treating pts
with life-threatening ventricular arrhythmias.
Key words:
Implantable cardioverter-defibrillator - Therapy - Analysis
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