Kurita Takashi
Division of Cardiology, National Cardiovascular Center.
Nihon Rinsho. 2002 Jul;60(7):1353-60.
Implantable Cardioverter-defibrillator(ICD) has been accepted as an effective therapy for the patients with life-threatening ventricular tachyarrhythmias in our country. Especially, down sizing and further development(e.g. atrial sensing/pacing) of ICD generator allows us to consider the indication of the device in the majority of VT/VF patients. Furthermore, not only secondary prevention trials but also primary prevention trials, comparing ICD with the antiarrhythmic agents(mainly amiodarone), demonstrate a superior efficacy of ICD to improve the patients mortality. Under these circumstances, we have to recognize the strong current toward the ICD at the present time. However, an essential problem of ICD therapy, not to prevent VT/VF recurrence, remains to be resolved.
植入式心脏复律除颤器(ICD)在我国已被公认为是治疗危及生命的室性快速性心律失常患者的有效方法。特别是,ICD发生器的小型化和进一步发展(如心房感知/起搏功能)使我们能够考虑将该设备应用于大多数室性心动过速/心室颤动(VT/VF)患者。此外,不仅二级预防试验,而且将ICD与抗心律失常药物(主要是胺碘酮)进行比较的一级预防试验均表明,ICD在降低患者死亡率方面具有更高的疗效。在这种情况下,我们必须认识到目前对ICD的强烈应用趋势。然而,ICD治疗的一个基本问题,即无法预防VT/VF复发,仍有待解决。