Mountantonakis Stavros, Hutchinson Mathew D
Department of Medicine, Cardiovascular Division, University of Pennsylvania, 3400 Spruce Street, 9 Founders Pavilion, Philadelphia, PA 19104, USA.
Curr Heart Fail Rep. 2009 Dec;6(4):236-44. doi: 10.1007/s11897-009-0033-5.
Despite a decline in overall cardiovascular mortality, the incidence of sudden cardiac death (SCD) continues to rise. Patients who survive a myocardial infarction (MI) with depressed ejection fraction are at particularly high risk for SCD. The development of implantable cardioverter-defibrillators (ICDs) has revolutionized SCD prevention; however, despite the current fervor for device implantation, many unresolved questions remain about risk stratification in post-MI patients. This review presents the current indications and timing of ICD implantation for primary and secondary prevention of SCD after MI. Several conventional and investigational methods of risk stratification after MI, as well as current controversies regarding device implantation in specific patient populations, are also reviewed.
尽管总体心血管死亡率有所下降，但心脏性猝死（SCD）的发生率仍在持续上升。射血分数降低的心肌梗死（MI）存活患者发生SCD的风险尤其高。植入式心脏复律除颤器（ICD）的发展彻底改变了SCD的预防；然而，尽管目前对设备植入热情高涨，但关于心肌梗死后患者的风险分层仍有许多未解决的问题。本综述介绍了心肌梗死后SCD一级和二级预防中ICD植入的当前适应证和时机。还综述了心肌梗死后几种传统和研究性的风险分层方法，以及特定患者群体中设备植入的当前争议。
