Goede ervaringen met een implanteerbare automatische defibrillator met transveneuze elektroden voor patiënten met levensbedreigende hartritmestoornissen

To describe the results of treatment of patients with a life-threatening arrhythmia by implantation of an second generation implantable cardioverter defibrillator with transvenous electrodes.

Design

Descriptive.

Setting

St.-Antonius Hospital, Nieuwegein, the Netherlands.

Method

In the period October 1991-February 1996 the ICD with transvenous electrodes was implanted in 44 patients. After a year the quality of life was assessed by written questionnaire.

Results

The in-hospital mortality was 144 (2), without peroperative death. During follow-up 4 patients died: 3 due to congestive heart failure and 1 due to sudden cardiac death. Within one year 50 of the patients had a therapeutical ICD discharge. In 3044 (68) patients antiarrhythmic drugs were prescribed to reduce the number of ICD discharges or because they were suffering from paroxysmal atrial fibrillation with high heart rates, which could result in an inappropriate ICD discharge. Quality of life analysis showed a good acceptance of the ICD, although 86 of the patients considered it a very serious limitation that they were not allowed to drive a motor vehicle anymore.

Conclusion

The ICD constitutes a major step forward in the treatment of life-threatening ventricular arrhythmias because the implantation is easier and follow-up shows adequate anti-arrhythmic effects and survival.