Singer I, Guarnieri T, Kupersmith J
Cardiovascular Division, University of Louisville, KY 40202.
Pacing Clin Electrophysiol. 1988 Dec;11(12):2250-62. doi: 10.1111/j.1540-8159.1988.tb05992.x.
The automatic implantable cardioverter defibrillator is an effective device for prevention of sudden cardiac death. Patients who require the implantation of the device often require permanent pacing for symptomatic bradyarrhythmias and may require antiarrhythmic drug therapy. Antiarrhythmic drugs may alter the defibrillation thresholds, arrhythmia cycle length and frequency, pacing thresholds and postshock excitability. Interactions between the defibrillator and the pacemaker may result in sensing problems, leading to multiple counting and inappropriate shocks, or ventricular fibrillation nondetection, sensing or capture failure post defibrillation and pacemaker reprogramming induced by defibrillator discharge. The potential for interactions will increase as the new generation of programmable defibrillators become clinically available, combining features of permanent pacemakers, antitachycardia pacemakers and defibrillators.
植入式自动心脏复律除颤器是预防心源性猝死的有效装置。需要植入该装置的患者通常因症状性缓慢性心律失常而需要永久性起搏，且可能需要抗心律失常药物治疗。抗心律失常药物可能会改变除颤阈值、心律失常周期长度和频率、起搏阈值以及电击后的兴奋性。除颤器与起搏器之间的相互作用可能导致感知问题，从而引起多次计数和不适当电击，或导致心室颤动未被检测到、除颤后感知或捕获失败以及除颤器放电引起的起搏器重新编程。随着新一代可编程除颤器投入临床使用，其结合了永久性起搏器、抗心动过速起搏器和除颤器的功能，相互作用的可能性将会增加。
