Delacretaz E, Schlaepfer J, Metzger J, Fromer M, Kappenberger L
Division of Cardiology, University Hospital, Lausanne, Switzerland.
Am J Cardiol. 2000 Nov 2;86(9A):52K-57K. doi: 10.1016/s0002-9149(00)01292-3.
Randomized controlled trials have shown superior survival rates with implantable cardioverter defibrillators (ICDs) compared with antiarrhythmic drugs in survivors of cardiac arrest and life-threatening ventricular tachyarrhythmias, as well as in high-risk patients with ischemic heart disease and inducible ventricular tachycardia (VT). Current defibrillators are small and implanted with techniques similar to standard pacemakers. They provide high-energy shocks for ventricular fibrillation (VF) and rapid VT, antitachycardia pacing for monomorphic VT, and antibradycardia pacing. Limited evidence suggests that ICD therapy is cost-effective when compared with other widely accepted treatments. The use of ICDs is likely to continue to expand in the future. Ongoing clinical trials will define further prophylactic indications of the ICD and clarify its cost-effectiveness ratio in different clinical settings.
随机对照试验表明，与抗心律失常药物相比，植入式心脏复律除颤器（ICD）可提高心脏骤停幸存者、危及生命的室性快速心律失常患者、患有缺血性心脏病且可诱发室性心动过速（VT）的高危患者的生存率。目前的除颤器体积小，采用与标准起搏器类似的技术植入。它们可为心室颤动（VF）和快速VT提供高能电击，为单形性VT提供抗心动过速起搏，以及为心动过缓提供起搏。有限的证据表明，与其他广泛接受的治疗方法相比，ICD治疗具有成本效益。ICD的使用在未来可能会继续扩大。正在进行的临床试验将进一步明确ICD的预防性适应症，并阐明其在不同临床环境中的成本效益比。
