Bryant Randall M
Interventional Electrophysiology and Pacing,University of Florida - Jacksonville/Gainesville,Jacksonville,Florida,United States of America.
Cardiol Young. 2017 Jan;27(S1):S121-S125. doi: 10.1017/S1047951116002353.
Following the sudden death of a friend in 1966, Dr Michel Mirowski began pioneering work on the first implantable cardioverter-defibrillator. By 1969 he had developed an experimental model and performed the first transvenous defibrillation. In 1970 he reported on the use of a "standby automatic defibrillator" that was tested successfully in dogs. He postulated that such a device "when adapted for clinical use, might be implanted temporarily or permanently in selected patients particularly prone to develop ventricular fibrillation and thus provide them with some degree of protection from sudden coronary death". In 1980 he reported on the first human implants of an "electronic device designed to monitor cardiac electrical activity, to recognise ventricular fibrillation and ventricular tachyarrhythmias … and then to deliver corrective defibrillatory discharges". Through innovations in circuitry, battery, and capacitor technologies, the current implantable cardioverter-defibrillator is 10 times smaller and exponentially more sophisticated than that first iteration. This article will review the inner workings of the implantable cardioverter-defibrillator and outline several features that make it the wonder in technology that it has become.
1966年，米歇尔·米罗夫斯基医生的一位朋友突然离世后，他开始了第一代植入式心脏复律除颤器的开创性工作。到1969年，他研发出了一个实验模型，并进行了首例经静脉除颤。1970年，他报告了一种“备用自动除颤器”的使用情况，该除颤器在狗身上测试成功。他推测，这样一种设备“若适用于临床，可临时或永久植入特定易发生心室颤动的患者体内，从而为他们提供一定程度的保护，防止冠状动脉性猝死”。1980年，他报告了首例植入“一种旨在监测心脏电活动、识别心室颤动和室性快速心律失常……然后发放纠正性除颤电击的电子设备”的人体病例。通过电路、电池和电容器技术的创新，如今的植入式心脏复律除颤器比第一代产品小了10倍，且复杂性呈指数级增长。本文将回顾植入式心脏复律除颤器的内部工作原理，并概述使其成为如今这项神奇技术的几个特点。
