Department of Arrhythmia, Institute of Cardiology, Warsaw, Poland.
Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Kardiol Pol. 2019;77(2):238-243. doi: 10.5603/KP.2019.0031.
Sudden cardiac death (SCD) is one of the main causes of mortality in developed countries. Implantable cardioverter-defibrillators (ICDs) have become a widely used and efficient method for SCD prevention in high-risk populations. Nevertheless, there are clinical situations in which the benefit of ICD is uncertain, such as: early postinfarction left ventricular dysfunction, reversible causes of cardiomyopathy, presence of temporary or permanent ICD contraindications in high-risk populations, or when ICD is not accepted by SCD prevention candidates. Wearable cardioverter-defibrillator (WCD) can be an alternative option in these clinical circumstances. However, even though WCDs are available in the United States and many countries of Western Europe, they are still not available in Poland. The authors present clinical and organisational recommendations for WCD use in Poland, with respect to medical evidence.
心脏性猝死(SCD)是发达国家主要的死亡原因之一。植入式心脏复律除颤器(ICD)已成为高危人群预防 SCD 的广泛应用且有效的方法。然而,在某些临床情况下,ICD 的获益并不确定,例如:急性心肌梗死后早期左心室功能障碍、心肌病的可逆病因、高危人群中存在暂时或永久性 ICD 禁忌证、或 ICD 不被 SCD 预防候选者接受等。在这些临床情况下,可穿戴式心脏复律除颤器(WCD)可以作为一种替代选择。然而,尽管 WCD 在美国和许多西欧国家都有供应,但在波兰仍不可用。作者根据医学证据,提出了波兰使用 WCD 的临床和组织建议。