Tan Timothy C, Sindone Andrew P, Denniss A Robert
Department of Cardiology, Westmead Hospital, Corner of Hawkesbury Road and Darcy Road, Westmead, NSW 2145, Australia.
Heart Lung Circ. 2012 Jun;21(6-7):338-51. doi: 10.1016/j.hlc.2012.03.124.
Heart failure is a condition which has an increasing incidence as the population ages, leading to increasing prevalence globally and in Australia. This condition also carries very high morbidity and mortality rates, attributed in part to electrical conduction disturbances which lead to sudden cardiac death or pathophysiological cardiac changes due to delayed activation of the left free wall and mechanical dyssynchrony. Current pharmacologic therapy has made impressive advances in improving survival rates in this population, but morbidity and mortality rates still remain high. Additionally, there is also a population of heart failure patients on optimal medical therapy who still suffer from functionally debilitating symptoms of heart failure. Device therapy comprising of implantable cardioverter-defibrillator (ICD) and cardiac resynchronisation therapy (CRT) are used to treat heart rhythm disturbances in a broad range of patients with heart disease and have now become established therapies in patients with heart failure receiving standard medical therapy. This review examines current evidence for the use of implantable cardioverter-defibrillators in the reduction of sudden cardiac death in patients with advanced systolic dysfunction and the use of cardiac resynchronisation therapy in improving ventricular performance as well as mortality and morbidity rates.
心力衰竭是一种随着人口老龄化发病率不断上升的疾病，导致全球和澳大利亚的患病率都在增加。这种疾病还具有非常高的发病率和死亡率，部分原因是导致心脏性猝死的电传导紊乱，或由于左游离壁激活延迟和机械不同步导致的病理生理心脏变化。目前的药物治疗在提高该人群的生存率方面取得了显著进展，但发病率和死亡率仍然很高。此外，还有一部分接受最佳药物治疗的心力衰竭患者仍然遭受着功能上使人衰弱的心力衰竭症状。包括植入式心脏复律除颤器（ICD）和心脏再同步治疗（CRT）在内的器械治疗被用于治疗广泛的心脏病患者的心律失常，现在已成为接受标准药物治疗的心力衰竭患者的既定治疗方法。这篇综述探讨了使用植入式心脏复律除颤器降低晚期收缩功能障碍患者心脏性猝死的当前证据，以及使用心脏再同步治疗改善心室功能以及死亡率和发病率的证据。
