可穿戴式心脏复律除颤器——玩具还是工具？
The Wearable Cardioverter/Defibrillator - Toy Or Tool?
作者信息
Duncker David, Veltmann Christian
机构信息
Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover.
出版信息
J Atr Fibrillation. 2016 Apr 30;8(6):1367. doi: 10.4022/jafib.1367. eCollection 2016 Apr-May.
Abstract
After the success story of implantable cardioverter/defibrillator systems, prevention of sudden cardiac death (SCD) remains one of the main duties in cardiology. For patients with unkown or transient risk profile for SCD, a wearable cardioverter/defibrillator (WCD) has been established for temporary and effective prevention of sudden arrhythmic death. Several studies have shown safety and efficacy of the WCD, even though randomized studies proving a mortality benefit are still lacking. This review provides an overview of actual WCD data and usage, special indications and possible risks and complications. WCD use is effective and adequate for temporary prevention of SCD in chosen populations. In particular, it provides secured time for sophisticated risk stratification to identify patients at persistent risk for SCD. Nevertheless, prospective randomized trials seem mandatory to prove a prognostic relevance and the economic value of this device.
摘要
在植入式心脏复律除颤器系统取得成功之后，预防心源性猝死（SCD）仍然是心脏病学的主要职责之一。对于SCD风险状况未知或短暂的患者，已确立了可穿戴式心脏复律除颤器（WCD）用于临时有效预防心律失常性猝死。多项研究已表明WCD的安全性和有效性，尽管仍缺乏证明其具有死亡率获益的随机研究。本综述概述了WCD的实际数据及使用情况、特殊适应症以及可能的风险和并发症。WCD的使用对于在特定人群中临时预防SCD是有效且充分的。特别是，它为进行复杂的风险分层以识别持续存在SCD风险的患者提供了可靠的时间。然而，前瞻性随机试验似乎对于证明该设备的预后相关性和经济价值是必不可少的。
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