Kamath Ganesh S, Mittal Suneet, Sherrid Mark V
Division of Cardiology, St Luke's and Roosevelt Hospitals, Columbia University College of Physicians & Surgeons, New York, NY 10019, USA.
Anadolu Kardiyol Derg. 2009 Dec;9 Suppl 2:32-40.
The implantable cardioverter-defibrillator (ICD) therapy is an established intervention for the prevention of sudden cardiac death (SCD) in patients with significant left ventricular dysfunction. Multiple randomized clinical trials have studied the use of ICD for the primary and secondary SCD. These studies were performed in patients with left ventricular dysfunction from coronary artery disease or dilated cardiomyopathy, and the marker of reduced ejection fraction has emerged for selecting patients who would benefit from ICD therapy. Currently, for most of these patients the decision to implant, or not, is determined by relatively straightforward paradigms. The same cannot be said for the genetic cardiac diseases associated with SCD--long QT syndrome, Brugada syndrome, hypertrophic cardiomyopathy, and arrhythmogenic right ventricular dysplasia. Indications for ICD in these conditions are very much a work-in-progress.
植入式心脏复律除颤器（ICD）疗法是预防左心室功能严重不全患者心源性猝死（SCD）的一种既定干预措施。多项随机临床试验研究了ICD用于一级和二级SCD预防的情况。这些研究是在患有冠状动脉疾病或扩张型心肌病导致左心室功能不全的患者中进行的，射血分数降低这一指标已成为筛选可能从ICD治疗中获益患者的依据。目前，对于大多数此类患者而言，植入或不植入ICD的决定是由相对简单的模式决定的。对于与SCD相关的遗传性心脏病——长QT综合征、Brugada综合征、肥厚型心肌病和致心律失常性右心室发育不良，情况并非如此。在这些情况下，ICD的适应证仍在不断完善中。
