Camm A John, Savelieva Irina
Department of Cardiological Sciences, St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
J Interv Card Electrophysiol. 2003 Oct;9(2):207-14. doi: 10.1023/a:1026288508343.
Three quite different forms of direct antiarrhythmic therapy are available for the treatment of cardiac arrhythmias: antiarrhythmic drugs, cardiac ablation and implantable devices (pacemakers and defibrillators). None of these therapies is fully effective and consequently they are increasingly combined. This combination therapy is often described as "hybrid" a term that implies fundamental different qualities of treatment which together provide some form of synergism. The mechanisms for the initiation and perpetuation of most cardiac arrhythmias are complex and multiple. It is therefore not surprising that single therapies are not completely effective. Theoretically the use of multiple different therapies allows more specific mechanisms of arrhythmia to be directly addressed. However, this is largely a theoretical concept that has only been strictly evaluated in a small number of studies. Studies of multiple therapies are difficult to perform unless the combination therapy is regarded as a strategy which can be compared to baseline, conventional treatment or one or more single constituent therapies from the combination. Despite the lack of formal studies there is a very substantial clinical experience which testifies to the value of hybrid therapy for the management of both atrial fibrillation and ventricular tachycardia/fibrillation.
抗心律失常药物、心脏消融术和植入式设备（起搏器和除颤器）。这些疗法都不是完全有效的，因此它们越来越多地被联合使用。这种联合疗法通常被称为“混合”疗法，这个术语意味着治疗的基本性质不同，它们共同提供某种形式的协同作用。大多数心律失常的起始和持续机制复杂且多样。因此，单一疗法不完全有效也就不足为奇了。理论上，使用多种不同疗法可以直接针对更具体的心律失常机制。然而，这在很大程度上只是一个理论概念，仅在少数研究中得到严格评估。除非将联合疗法视为一种可与基线、传统治疗或联合疗法中的一种或多种单一组成疗法进行比较的策略，否则很难进行多种疗法的研究。尽管缺乏正式研究，但有非常丰富的临床经验证明混合疗法在治疗心房颤动和室性心动过速/颤动方面的价值。
