Romanò Massimo, Zorzoli Federica, Bertona Roberta, Graziano Gabriella, Villani Rosvaldo
S.C. Cardiologia, Ospedale Civile di Vigevano, ASST Provincia di Pavia - Centro Universitario Interdipartimentale di Ricerca in Cure Palliative, Università degli Studi, Milano.
S.C. Cardiologia, Ospedale Civile di Vigevano, ASST Provincia di Pavia.
G Ital Cardiol (Rome). 2018 Jul-Aug;19(7):448-459. doi: 10.1714/2938.29541.
Sudden cardiac death (SCD) can affect patients with ischemic or non-ischemic left ventricular dysfunction. Automatic implantable cardioverter-defibrillator (ICD) implantation is the most effective option for the treatment of malignant ventricular tachyarrhythmias; however, the procedure is burdened with known significant risks, even in the long term.In patients at high risk of SCD, either real or perceived, without a definite indication to ICD implantation, wearable cardioverter-defibrillators have been shown to offer effective temporary protection in different clinical settings, for patients with recent high-risk myocardial infarction with left ventricular dysfunction, even after myocardial revascularization procedures, heart failure with reduced ejection fraction, newly diagnosed dilated cardiomyopathy, ICD post-explant phase for infection, and bridge to cardiac transplantation.The purpose of this review is to describe the technical aspects and clinical results available in the literature on the use of wearable cardioverter-defibrillators, with particular reference to safety, efficacy, costs and patient selection, together with current and unconventional indications.The authors also report the first data related to their personal experience.
心脏性猝死（SCD）可影响患有缺血性或非缺血性左心室功能障碍的患者。植入式自动心脏复律除颤器（ICD）植入是治疗恶性室性快速心律失常最有效的选择；然而，即使从长期来看，该手术也存在已知的重大风险。对于存在SCD高风险（无论是实际存在还是感知到的）且无明确ICD植入指征的患者，穿戴式心脏复律除颤器已被证明在不同临床环境中能为近期发生高危心肌梗死伴左心室功能障碍的患者提供有效的临时保护，即使在心肌血运重建术后、射血分数降低的心力衰竭、新诊断的扩张型心肌病、因感染处于ICD取出后阶段以及作为心脏移植的过渡阶段。本综述的目的是描述文献中关于穿戴式心脏复律除颤器使用的技术方面和临床结果，特别提及安全性、有效性、成本和患者选择，以及当前和非常规适应证。作者还报告了与其个人经验相关的首批数据。
