Biffi Mauro
Institute of Cardiology, Policlinico S. Orsola-Malpighi, University of Bologna, Italy.
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.
Appropriate ICD programming is the key to prevent inappropriate shock delivery, that is closely associated to a negative patients' outcome.
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.
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.
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.
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。
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。
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。
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。
