Singh Steven, Murawski Matthew M
Veterans Affairs Medical Center, Washington, DC 20422, USA.
J Cardiovasc Pharmacol Ther. 2007 Sep;12(3):175-80. doi: 10.1177/1074248407305608.
Implantable cardioverter defibrillators (ICDs) are increasingly used for the prevention of sudden cardiac death in patients with life-threatening ventricular arrhythmias (VAs); however, there is a potential for severe and debilitating anxiety caused by symptoms associated with ICD therapy and anticipation of shocks. Anxiety is a psycho-logic stressor, including physiologic components that may lead to adrenergic excitation triggering new arrhythmias and ICD therapies. This often requires concomitant antiarrhythmic medication to reduce the frequency of shocks and symptomatic arrhythmias treated by anti-tachycardia pacing. Although published studies have documented the efficacy of currently available antiarrhythmics, they have limitations in patients with heart failure, may affect the defibrillation threshold, and/or have been associated with major side-effects. In conclusion, for the patient with an ICD experiencing symptomatic ventricular tachycardia (VTs) episodes or ICD shocks, there is a need for pharmacologic therapy to reduce the incidence of such events without affecting the performance of the ICD or causing major side-effects.
植入式心脏复律除颤器（ICD）越来越多地用于预防有危及生命的室性心律失常（VA）患者的心脏性猝死；然而，ICD治疗相关症状以及对电击的预期可能会导致严重且使人衰弱的焦虑。焦虑是一种心理应激源，包括可能导致肾上腺素能兴奋从而引发新的心律失常和ICD治疗的生理成分。这通常需要同时使用抗心律失常药物，以减少电击频率和抗心动过速起搏治疗的有症状心律失常。尽管已发表的研究记录了现有抗心律失常药物的疗效，但它们在心力衰竭患者中存在局限性，可能会影响除颤阈值，和/或与严重副作用相关。总之，对于经历有症状室性心动过速（VT）发作或ICD电击的ICD患者，需要药物治疗来降低此类事件的发生率，同时不影响ICD的性能或引起严重副作用。
