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室性心动过速的低能量心脏复律：少即是多。

Low-energy cardioversion of ventricular tachycardia: When less is more.

作者信息

Burri Haran, Moretti Francesco, Meyer Philippe

机构信息

Cardiology Department, Geneva University Hospital, Geneva, Switzerland.

Cardiology Department, Geneva University Hospital, Geneva, Switzerland.

出版信息

Indian Pacing Electrophysiol J. 2017 Mar-Apr;17(2):44-47. doi: 10.1016/j.ipej.2017.02.002. Epub 2017 Feb 20.

DOI:10.1016/j.ipej.2017.02.002
PMID:29072992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5405749/
Abstract

Herein we report the case of a patient who was admitted in ventricular tachycardia after having received multiple ineffective (and sometimes pro-arrhythmic) high-energy internal shocks from his ICD and who was finally successfully treated by a commanded low-energy internal cardioversion of 0.6 J. This article revisits the use of low-energy shocks and discusses their electrophysiogical mechanisms and clinical implications.

摘要

在此，我们报告一例患者，该患者在接受了来自其植入式心律转复除颤器（ICD）的多次无效（有时甚至是促心律失常）高能量体内电击后出现室性心动过速，最终通过0.6焦耳的指令性低能量体内心脏转复成功治疗。本文重新审视了低能量电击的应用，并讨论了其电生理机制和临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/5405749/6b878d762d26/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/5405749/eab2f0c763f2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/5405749/6b878d762d26/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/5405749/eab2f0c763f2/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/5405749/6b878d762d26/gr2.jpg

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1
Low-energy cardioversion of ventricular tachycardia: When less is more.室性心动过速的低能量心脏复律：少即是多。
Indian Pacing Electrophysiol J. 2017 Mar-Apr;17(2):44-47. doi: 10.1016/j.ipej.2017.02.002. Epub 2017 Feb 20.
2
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
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Survival after shock therapy in implantable cardioverter-defibrillator and cardiac resynchronization therapy-defibrillator recipients according to rhythm shocked. The ALTITUDE survival by rhythm study.根据电击节律对植入式心脏复律除颤器和心脏再同步治疗除颤器受者电击治疗后的生存情况。节律研究中的 ALTITUDE 生存情况。
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Etiology and Programming Effects on Shock Efficacy in ICD Recipients.植入式心律转复除颤器（ICD）接受者中病因及编程对电击疗效的影响
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Efficacy of automatic multimodal device therapy for ventricular tachyarrhythmias as delivered by a new implantable pacing cardioverter-defibrillator. Results of a European multicenter study of 102 implants.新型植入式起搏除颤器所提供的自动多模式设备治疗室性快速心律失常的疗效。一项欧洲多中心研究（涉及102例植入）的结果
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本文引用的文献

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2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing.2015年心律学会（HRS）/欧洲心律协会（EHRA）/亚太心律学会（APHRS）/拉丁美洲心律学会（SOLAECE）关于植入式心脏复律除颤器最佳程控与测试的专家共识声明
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Antitachycardia pacing for very fast ventricular tachycardia and low-energy shock for ventricular arrhythmias in patients with implantable defibrillators.植入式除颤器患者的快速室性心动过速的抗心动过速起搏和低能量电击治疗室性心律失常。
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Impact of shock energy and ventricular rhythm on the success of first shock therapy: the ALTITUDE first shock study.
冲击能量和室性节律对首次电击治疗成功的影响：ALTITUDE 首次电击研究。
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Using the upper limit of vulnerability to assess defibrillation efficacy at implantation of ICDs.使用易损性上限评估植入式心律转复除颤器（ICD）植入时的除颤效果。
Pacing Clin Electrophysiol. 2007 Feb;30(2):258-70. doi: 10.1111/j.1540-8159.2007.00659.x.
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Mechanisms of enhanced shock-induced arrhythmogenesis in the rabbit heart with healed myocardial infarction.愈合心肌梗死后兔心脏中增强的休克诱导心律失常发生机制。
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Internal defibrillation: pain perception of low energy shocks.
Pacing Clin Electrophysiol. 2002 Jul;25(7):1090-3. doi: 10.1046/j.1460-9592.2002.01090.x.
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Effect of ventricular shock strength on cardiac hemodynamics.
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A prospective randomized repeat-crossover comparison of antitachycardia pacing with low-energy cardioversion.抗心动过速起搏与低能量心脏复律的前瞻性随机重复交叉比较。
Circulation. 1993 Jun;87(6):1889-96. doi: 10.1161/01.cir.87.6.1889.