Bokeria L A, Neminushchiy N M, Postol A S
Sechenov First Moscow State Medical University.
Kardiologiia. 2018 Dec 25;58(12):76-84. doi: 10.18087/cardio.2018.12.10197.
The article covers the development of the problem of sudden cardiac death prevention with the implantable cardioverter-defibrillators from the moment of creation of these devices to our days. The current concept of primary prevention of sudden cardiac death, based on the severity of manifestation of heart failure and left ventricular dysfunction, is not effective enough. Its practical application is difficult because it requires mass application of implantable defibrillators, with low predictive accuracy of these criteria in terms of development of life-threatening arrhythmias. The development of methods for visualizing the myocardium, allowing to assess the severity of myocardial fibrosis, as well as the possibilities of medical genetics, at the present stage, allows us to clarify indications for implantation of cardioverter-defibrillators and thereby significantly improve the concept of preventing sudden cardiac death with these instruments.
本文涵盖了从植入式心脏复律除颤器发明至今，心脏性猝死预防问题的发展历程。基于心力衰竭表现的严重程度和左心室功能障碍的心脏性猝死一级预防的当前概念，效果并不理想。其实际应用困难，因为这需要大规模应用植入式除颤器，而这些标准在预测危及生命的心律失常发生方面的准确性较低。现阶段，心肌可视化方法的发展使我们能够评估心肌纤维化的严重程度，医学遗传学的发展也使我们能够明确心脏复律除颤器植入的适应症，从而显著改进使用这些器械预防心脏性猝死的概念。
