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目的:通过对缺血性心肌病患者血运重建后超声心动图随访及植入型心律转复除颤器(ICD)植入情况进行分析，寻找影响ICD植入的相关因素。方法:本研究为单中心的队列研究，收集2005年1月至2014年12月在北京安贞医院接受经皮冠状动脉介入治疗并置入药物洗脱支架或冠状动脉旁路移植术且左心室射血分数(LVEF)≤40%的患者资料，分析血运重建后不同时间段LVEF再评估的人次。在术后3个月LVEF≤35%的患者中，根据是否植入ICD分组，通过多因素Logistic回归分析，寻找影响ICD植入的独立影响因素。结果:共入选2 852例患者，年龄(66.2±10.5)岁，其中男2 366例(83.0%，2 366/2 852)。术后3个月内共162例患者死亡。仅1 105例(51.2%，1 105/2 160)患者完成血运重建3个月后LVEF的再评估。血运重建后，患者LVEF从术前36.1%±4.4%提高到45.1%±11.3% (n P<0.001)，但仍有229例(20.7%，229/1 105)患者术后LVEF≤35%。术后3个月LVEF≤35%的患者中ICD植入率仅为6.5%。ICD植入组全因死亡率显著低于未植入组(7.7%对35.5%，n P＝0.040)。室性心动过速/心室颤动病史(n OR＝12.67，95%n CI 1.87~85.59，n P＝0.009)与ICD植入独立相关。n 结论:缺血性心肌病患者血运重建后LVEF再评估的比例偏低，而符合ICD植入适应证但未植入的患者比例偏高。临床现状与指南推荐的较大差距表明，我国血运重建后心脏性猝死防治工作任重道远。“,”Objective:To investigate the status of implantable cardioverter defibrillator (ICD) implantation in patients with ischemic cardiomyopathy after revascularization, and to find the relevant factors affecting ICD implantation in China.Methods:This study was a single-center cohort study.Patients with left ventricular ejection fraction (LVEF) of 40% or less who received coronary artery bypass grafting or percutaneous coronary intervention with drug-eluting stent in Beijing Anzhen Hospital from January 2005 to December 2014 were enrolled.Three months after revascularization, patients with LVEF≤35% were divided into two groups according to whether ICD implantation was performed.Multivariate Logistic regression was used to identify independent correlates of ICD implantation.Results:Two thousand eight hundred and fifty-two patients were enrolled.The average age at baseline was (66.2±10.5) years.Among them, 2 366 (83.0%, 2 366/2 852) were male.One hundred and sixty-two patients died within 3 months after revascularization.Only 1 105 (51.2%, 1 105/2 160) patients had LVEF reassessment 3 months after revascularization.The baseline LVEF was improved from 36.1%±4.4% to 45.1%±11.3% (n P<0.001). However, 229 (20.7%, 229/1 105) patients had LVEF ≤35%.The rate of ICD implantation was 6.5% in patients with LVEF≤35%.Patients with ICD were associated with lower all-cause mortality compared with patients without ICD (7.7% vs. 35.5%,n P=0.040). Multivariate Logistic regression analysis indicated that the history of ventricular tachycardia/ventricular fibrillation was independently associated with ICD implantation (n OR=12.67, 95%n CI 1.87-85.59, n P=0.009).n Conclusion:The rate of ICD implantation in patients with ischemic cardiomyopathy was extremely low.It is necessary to further improve the utilization of ICD to prevent sudden cardiac death after revascularization.