Saksena S, Camm A J
Circulation. 1992 Jun;85(6):2316-21. doi: 10.1161/01.cir.85.6.2316.
Implantable cardioverter-defibrillator therapy is now widely used for the treatment of symptomatic patients with documented or suspected life-threatening VTs. Although sudden death recurrence in ICD recipients is virtually eliminated, the extent of benefit both with respect to cardiac mortality and total survival in this patient population remains to be accurately quantitated, particularly vis-à-vis alternative antiarrhythmic therapies. Advanced device and lead systems can be expected to further improve both patient survival and quality of life after implant. The economic impact of unrestrained proliferation in ICD therapy can be enormous; however, available cost-benefit analyses support judicious use of this therapy with comparable economic impact to other accepted cardiovascular therapies. Such prospective risk stratification becomes economically essential when considering expanding its application to asymptomatic or minimally symptomatic populations at potential risk for future cardiac arrest.
植入式心脏复律除颤器疗法目前广泛用于治疗有记录的或疑似危及生命的室性心动过速的症状性患者。尽管植入式心脏复律除颤器接受者的猝死复发几乎已被消除，但该患者群体在心脏死亡率和总生存率方面的获益程度仍有待准确量化，特别是相对于其他抗心律失常疗法而言。先进的设备和导线系统有望进一步改善植入后患者的生存率和生活质量。植入式心脏复律除颤器疗法无节制扩散的经济影响可能是巨大的；然而，现有的成本效益分析支持明智地使用这种疗法，其经济影响与其他公认的心血管疗法相当。当考虑将其应用扩大到未来有心脏骤停潜在风险的无症状或症状轻微的人群时，这种前瞻性风险分层在经济上变得至关重要。
