Department of Pediatrics, Oregon Health and Science University, Portland Oregon, USA.
Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
JACC Clin Electrophysiol. 2022 Sep;8(9):1165-1172. doi: 10.1016/j.jacep.2022.07.020.
Children, adolescents, and young adults with conditions such as cardiomyopathies and channelopathies are at higher risk of sudden cardiac death caused by lethal arrhythmias, especially ventricular fibrillation. Timely defibrillation saves lives. Patients thought to be at significantly high risk of sudden death typically undergo placement of an implantable cardioverter-defibrillator. Patients thought to be at lower risk are typically followed medically but do not undergo implantable cardioverter-defibrillator placement. However, low risk does not equal no risk. Compared with the general population, many of these patients are at significantly higher risk for lethal arrhythmias. We make the case that such individuals and families will benefit from having an at-home automatic external defibrillator. Used in conjunction with conventional measures such as training on cardiopulmonary resuscitation, an at-home automatic external defibrillator could lead to significantly shortened time to defibrillation with better overall and neurological survival. We recommend that the cost of such home automatic external defibrillators should be covered by medical insurance.
患有心肌病和离子通道病等疾病的儿童、青少年和年轻人,由于致命性心律失常(尤其是心室颤动)而发生心源性猝死的风险较高。及时除颤可挽救生命。通常认为有明显猝死风险的患者需要植入植入式心律转复除颤器。风险较低的患者通常通过药物治疗进行随访,但不进行植入式心律转复除颤器的放置。然而,低风险并不等于无风险。与一般人群相比,这些患者中许多人发生致命性心律失常的风险显著增加。我们认为,此类个人和家庭将受益于配备家用自动体外除颤器。与心肺复苏培训等常规措施结合使用,家用自动体外除颤器可以显著缩短除颤时间,提高整体和神经存活率。我们建议医疗保险应涵盖此类家用自动体外除颤器的费用。