Moss Arthur J
Department of Medicine, University of Rochester Medical Center, Rochester, New York 14542, USA.
J Cardiovasc Electrophysiol. 2003 Sep;14(9 Suppl):S96-8. doi: 10.1046/j.1540-8167.14.s9.5.x.
The MADIT-I study was a proof-of-principle study, and this randomized trial showed that the implantable cardioverter defibrillator (ICD) saves lives in high-risk patients with coronary heart disease. The MADIT-II study showed that prophylactic ICD therapy was associated with significantly improved survival in patients with ischemic cardiomyopathy, as defined by documented coronary heart disease and advanced left ventricular dysfunction, without requiring screening for ventricular arrhythmias or inducibility by electrophysiologic testing. Taken together, these two trials, as well as the results from several other randomized ICD trials, indicate that ICD therapy is indicated in coronary patients who meet MADIT-I or MADIT-II eligibility criteria and are not excluded by major noncardiac comorbidity.
MADIT-I研究是一项原理验证性研究，这项随机试验表明，植入式心脏复律除颤器（ICD）可挽救冠心病高危患者的生命。MADIT-II研究表明，对于有缺血性心肌病的患者，预防性ICD治疗可显著提高生存率，缺血性心肌病的定义为有冠心病记录且存在严重左心室功能障碍，无需通过电生理检查筛查室性心律失常或诱发性。综合来看，这两项试验以及其他几项ICD随机试验的结果表明，符合MADIT-I或MADIT-II纳入标准且未被严重非心脏合并症排除的冠心病患者适合接受ICD治疗。
