The Contrast Of Therapeutic Efficiency To Prevention And Cure Sudden Cardiac Death With ICD, CRT, Or CRT-D

Objective: To contrast the curative effcet for sudden cardiac death with ICD, CRT, or CRT-D and discuss the feasibility and rationality of implementing on technic.Methods: 89 patients with high crisis of sudden cardiac death were collected gradually. According to the indication and the economic capability . 43 cases were implanted with ICD(5 cases implanted with double ICD,7 patients were replaced at the second time), 40 cases were implanted with CRT, 6 cases were implanted with CRT-D respectively. The clinic character before operation, process of surgery, expense for therapy , time in hospital, event of death and cardiac incidents were noted, grade of cardiac function in NYHA, LVEF, 6MWT, LVEDD and QOL were measured resgularly. All the data were compared in every group and between groups.Results: Percentage of success was 100% in the operation of implanting ICD, 100% in CRT-D, 87.5% in CRT ,. There is no death in all. 84 cases were followed up from 3 months to 97 months. Average was 27±18months. In the period of following up, 7 patients died in the group of ICD(16.3%) and 4 died of CHF;14 patients(contrast to group of ICD P=0.019) died in the group of CRT( 40%), for the cause of death, six was CHF(controst to group of ICD P=0.303),six of another was severe arrhythmia. There was no death in the group of CRT-D. 950 events of VT/VF attacked in 36 cases were prevented by ICD and CRT-D successfully(ratio is 99.9%) in 49 cases planted with ICD or CRT-D except for 1 failed of exhuausting in battery. The index for evalute cardiac function of LVEF,6MWT,LVEDD and grade of cardiac function in NYHA in 29 cases improved in different degree contrast to the time before operation in 41 cases planted with CRT or CRT-D, forthermore, the improving hold to the end of follow-up (70.7%) . Cardiac function in the other 11 cases improved also, but not persist to the end of follow-up. Grade of QOL of 3 groups all improved after the treatment. The average time in hospital of patients implanted with CRT-D was the shortest.