植入式心律转复除颤器（ICD）程控
ICD programming.
作者信息
Biffi Mauro
机构信息
Institute of Cardiology, Policlinico S. Orsola-Malpighi, University of Bologna, Italy.
出版信息
Indian Heart J. 2014 Jan-Feb;66 Suppl 1(Suppl 1):S88-100. doi: 10.1016/j.ihj.2013.11.007. Epub 2013 Dec 20.
Abstract
BACKGROUND
Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome.
METHODS
Review of the literature on ICD therapy to generate ICD programmings that can be applied to the broad population of ICD and CRT-D carriers.
RESULTS
Arrhythmia detection should occur with a detection time ranging 9″-12″ in the VF zone, and 15″-60″ in the VT zone. Discriminator should be applied at least up to 200 bpm. ATP therapy is applied to all VTs up to 250 bpm, with a success rate of 70%. Inappropriate shocks should occur in <3.6% of patients.
CONCLUSION
Tailored ICD programming can be achieved following evidence from large ICD trials. Pre-defined settings that are saved on the programmer and that can be uploaded at device implantation help to ensure optimal programming and to avoid random errors.
摘要
背景
合适的植入式心律转复除颤器（ICD）程控是预防不适当电击发放的关键，这与患者的不良预后密切相关。
方法
回顾有关ICD治疗的文献，以制定可应用于广大ICD和心脏再同步治疗除颤器（CRT-D）携带者人群的ICD程控方案。
结果
在室颤（VF）区，心律失常检测时间应在9秒至12秒之间，在室性心动过速（VT）区为15秒至60秒。鉴别器应至少应用至200次/分钟。抗心动过速起搏（ATP）治疗应用于所有心率高达250次/分钟的室性心动过速，成功率为70%。不适当电击应发生在<3.6%的患者中。
结论
根据大型ICD试验的证据可实现个性化的ICD程控。保存在程控仪上并可在设备植入时上传的预定义设置有助于确保最佳程控并避免随机误差。
相似文献
1
ICD programming.植入式心律转复除颤器（ICD）程控
Indian Heart J. 2014 Jan-Feb;66 Suppl 1(Suppl 1):S88-100. doi: 10.1016/j.ihj.2013.11.007. Epub 2013 Dec 20.
2
[Long-term outcome after cardioverter-defibrillator implantation in patients with Brugada syndrome].[布加综合征患者植入心脏复律除颤器后的长期预后]
Zhonghua Xin Xue Guan Bing Za Zhi. 2015 Aug;43(8):690-4.
3
Reduction of inappropriate ICD therapies in patients with primary prevention of sudden cardiac death: DECREASE study.降低心脏性猝死一级预防患者不适当植入式心律转复除颤器（ICD）治疗：DECREASE研究
Clin Res Cardiol. 2015 Dec;104(12):1021-32. doi: 10.1007/s00392-015-0870-z. Epub 2015 May 23.
4
Arrhythmia rate distribution and tachyarrhythmia therapy in an ICD population: results from the INTRINSIC RV trial.心律失常发生率分布和心动过速性心律失常治疗：来自 INTRINSIC RV 试验的结果。
Heart Rhythm. 2012 Mar;9(3):351-8. doi: 10.1016/j.hrthm.2011.10.018. Epub 2011 Oct 19.
5
Reduction in inappropriate therapies through device programming in subcutaneous implantable defibrillator patients: data from clinical practice.通过皮下植入式除颤器患者的设备程控减少不适当治疗：来自临床实践的数据。
Europace. 2023 May 19;25(5). doi: 10.1093/europace/euac234.
6
Inductionless or limited shock testing is possible in most patients with implantable cardioverter- defibrillators/cardiac resynchronization therapy defibrillators: results of the multicenter ASSURE Study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations).大多数植入式心脏复律除颤器/心脏再同步治疗除颤器患者可行无诱导或有限电击测试：多中心ASSURE研究（心律失常单次电击除颤阈值测试与易损性上限：植入式心脏复律除颤器植入的风险降低评估）结果
Circulation. 2007 May 8;115(18):2382-9. doi: 10.1161/CIRCULATIONAHA.106.663112. Epub 2007 Apr 30.
7
Implantable cardioverter-defibrillator programming and electrical storm: Results of the OBSERVational registry On long-term outcome of ICD patients (OBSERVO-ICD).植入式心脏复律除颤器程控与电风暴：ICD患者长期预后观察登记研究（OBSERVO-ICD）结果
Heart Rhythm. 2016 Oct;13(10):1987-92. doi: 10.1016/j.hrthm.2016.06.007. Epub 2016 Jun 9.
8
Outcomes of defibrillator therapy in catecholaminergic polymorphic ventricular tachycardia.儿茶酚胺能多形性室性心动过速的除颤治疗结果
Heart Rhythm. 2014 Jan;11(1):58-66. doi: 10.1016/j.hrthm.2013.10.027. Epub 2013 Oct 11.
9
Single-chamber ICD, single-zone therapy in primary and secondary prevention patients: the simpler the better?单腔植入式心律转复除颤器，一级和二级预防患者的单区治疗：越简单越好？
J Interv Card Electrophysiol. 2012 Dec;35(3):343-9. doi: 10.1007/s10840-012-9735-9. Epub 2012 Oct 19.
10
Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis.旨在减少不必要的植入式心脏复律除颤器治疗的编程策略对死亡率的影响：系统评价和荟萃分析。
Circ Arrhythm Electrophysiol. 2014 Feb;7(1):164-70. doi: 10.1161/CIRCEP.113.001217. Epub 2014 Jan 20.
引用本文的文献
1
Head-to-Head Comparison of Single- Versus Dual-Chamber ICD Discriminators for Tachyarrhythmia Detection: A Single-Manufacturer, Remote Monitoring-Based Bicentric Study.单腔与双腔植入式心律转复除颤器鉴别器对快速性心律失常检测的头对头比较：一项基于远程监测的单制造商双中心研究。
J Clin Med. 2025 Aug 19;14(16):5859. doi: 10.3390/jcm14165859.
2
Noninvasive Impedance Analysis During S-ICD Insertion Provides Justification for Defibrillation Based Testing Deferment.皮下植入式心律转复除颤器（S-ICD）植入过程中的无创阻抗分析为推迟除颤测试提供了依据。
Pacing Clin Electrophysiol. 2025 Jun;48(6):578-586. doi: 10.1111/pace.15199. Epub 2025 May 12.
3
Electrical manipulation of the failing heart.电刺激衰竭心脏
Heart Fail Rev. 2018 Nov;23(6):885-896. doi: 10.1007/s10741-018-9732-x.
4
Surface Electrocardiogram Predictors of Sudden Cardiac Arrest.心脏骤停的体表心电图预测指标
Ochsner J. 2016 Fall;16(3):280-9.
5
ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature.1:1室房传导时室上性心动过速与室性心动过速的ICD鉴别：文献综述
Indian Pacing Electrophysiol J. 2016 Feb 12;15(5):236-44. doi: 10.1016/j.ipej.2016.02.006. eCollection 2015 Sep-Oct.
本文引用的文献
1
Safety and efficacy of a totally subcutaneous implantable-cardioverter defibrillator.完全皮下植入式心脏除颤器的安全性和有效性。
Circulation. 2013 Aug 27;128(9):944-53. doi: 10.1161/CIRCULATIONAHA.113.003042.
2
The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) randomized controlled trial: phase 1 results on dynamics of early intervention with remote monitoring.监测再同步化设备与心脏患者（MORE-CARE）随机对照试验：早期干预远程监测动态的1期结果
J Med Internet Res. 2013 Aug 21;15(8):e167. doi: 10.2196/jmir.2608.
3
From lead management to implanted patient management: systematic review and meta-analysis of the last 15 years of experience in lead extraction.从铅管理到植入患者管理：对过去 15 年铅提取经验的系统回顾和荟萃分析。
Expert Rev Med Devices. 2013 Jul;10(4):551-73. doi: 10.1586/17434440.2013.811837.
4
Effect of long-detection interval vs standard-detection interval for implantable cardioverter-defibrillators on antitachycardia pacing and shock delivery: the ADVANCE III randomized clinical trial.长检测间隔与标准检测间隔对植入式心脏复律除颤器抗心动过速起搏和电击治疗效果的影响：ADVANCE III 随机临床试验。
JAMA. 2013 May 8;309(18):1903-11. doi: 10.1001/jama.2013.4598.
5
Rapid-rate nonsustained ventricular tachycardia found on implantable cardioverter-defibrillator interrogation: relationship to outcomes in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).植入式心脏复律除颤器检测时发现快速性非持续性室性心动过速：与 SCD-HeFT（心力衰竭中的猝死试验）结局的关系。
J Am Coll Cardiol. 2013 May 28;61(21):2161-8. doi: 10.1016/j.jacc.2013.02.046. Epub 2013 Mar 26.
6
A clinical trial of ICD programming.植入式心律转复除颤器（ICD）程控的一项临床试验。
N Engl J Med. 2013 Mar 7;368(10):965. doi: 10.1056/NEJMc1300614.
7
Reduction in inappropriate therapy and mortality through ICD programming.通过 ICD 编程减少不适当的治疗和死亡率。
N Engl J Med. 2012 Dec 13;367(24):2275-83. doi: 10.1056/NEJMoa1211107. Epub 2012 Nov 6.
8
Implant and long-term evaluation of atrial signal amplification in a single-lead ICD.单腔植入式心律转复除颤器中的心房信号放大植入及长期评估
Pacing Clin Electrophysiol. 2012 Sep;35(9):1119-25. doi: 10.1111/j.1540-8159.2012.03452.x. Epub 2012 Jun 26.
9
Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study.远程监测可减少心力衰竭合并植入式除颤器患者的医疗保健使用并改善其医疗护理质量：心力衰竭合并植入式除颤器患者管理策略的演变研究（EVOLVO 研究）。
Circulation. 2012 Jun 19;125(24):2985-92. doi: 10.1161/CIRCULATIONAHA.111.088971. Epub 2012 May 24.
10
Clinical experience of entirely subcutaneous implantable cardioverter-defibrillators in children and adults: cause for caution.完全皮下植入式心脏除颤器在儿童和成人中的临床应用经验：需要谨慎。
Eur Heart J. 2012 Jun;33(11):1351-9. doi: 10.1093/eurheartj/ehs017. Epub 2012 Mar 8.
Zotero 插件