Farwell D, Gollob M H
Arrhythmia Research Laboratory, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Minerva Cardioangiol. 2007 Jun;55(3):379-84.
Clinical trials provide evidence that an empiric approach of implantable cardioverter-defibrillator (ICD) implantation in heart failure patients (ejection fraction =/< 35%) with mild to moderate symptoms reduces mortality rate as compared to the best available medical therapy. However, ejection fraction alone is unable to predict death by progressive pump failure or sudden arrhythmic death, and consequently over half of all patients will not require device therapy over long-term follow-up. Thus, the approach of empiric ICD implantation results in excessive cost in the absence of more specific risk stratification for sudden death. This review summarizes the current noninvasive risk stratifying strategies available in predicting susceptibility to sudden arrhythmic death in heart failure populations.
临床试验表明，与最佳可用药物治疗相比，对症状轻至中度的心力衰竭患者（射血分数≤35%）采用经验性植入式心脏复律除颤器（ICD）的方法可降低死亡率。然而，仅射血分数无法预测因进行性泵衰竭或心律失常性猝死导致的死亡，因此在长期随访中，超过一半的患者不需要器械治疗。因此，在缺乏更具体的猝死风险分层的情况下，经验性植入ICD的方法会导致成本过高。本综述总结了目前用于预测心力衰竭人群心律失常性猝死易感性的非侵入性风险分层策略。
