Schläpfer J, Kappenberger L, Fromer M
Division of Cardiology, University Hospital, Lausanne, Switzerland.
Am J Cardiol. 1999 Mar 11;83(5B):101D-103D. doi: 10.1016/s0002-9149(98)01010-8.
Implantable cardioverter defibrillators (ICDs) were developed to prevent sudden cardiac death in patients with ventricular tachycardia (VT) or ventricular fibrillation (VF). Their safety and efficacy have been proved in multiple retrospective and prospective studies. Many of the published trials were directed at secondary prevention for patients who had already had a sudden cardiac death or a sustained VT. For primary prevention, the information available is limited, as only 2 trials have yet been published. Ongoing trials will probably allow us to broaden the indications for prophylactic ICD implantation. Justification of the risk will have to be evaluated against complexity of the implant, the latter including not only cost but quality of life and morbidity associated with an ICD. However, our efforts still have to be directed to improve risk stratification and to decrease the complexity of the procedure.
植入式心脏复律除颤器（ICD）旨在预防室性心动过速（VT）或室颤（VF）患者的心脏性猝死。多项回顾性和前瞻性研究已证实其安全性和有效性。许多已发表的试验针对的是已经发生过心脏性猝死或持续性室速的患者进行二级预防。对于一级预防，现有信息有限，因为仅有两项试验已发表。正在进行的试验可能会使我们扩大预防性植入ICD的适应证。必须根据植入的复杂性来评估风险的合理性，植入的复杂性不仅包括成本，还包括与ICD相关的生活质量和发病率。然而，我们仍需致力于改善风险分层并降低手术的复杂性。
