Leong Andrew M, Arnold Ahran D, Whinnett Zachary I
National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK.
J Cardiovasc Dev Dis. 2024 Mar 20;11(3):92. doi: 10.3390/jcdd11030092.
Implantable cardioverter defibrillators (ICDs) have a long history and have progressed significantly since the 1980s. They have become an essential part of the prevention of sudden cardiac death, with a proven survival benefit in selected patient groups. However, with more recent trials and with the introduction of contemporary heart failure therapy, there is a renewed interest and new questions regarding the role of a primary prevention ICD, especially in patients with heart failure of non-ischaemic aetiology. This review looks at the history and evolution of ICDs, appraises the traditional evidence for ICDs and looks at issues relating to patient selection, risk stratification, competing risk, future directions and a proposed contemporary ICD decision framework.
植入式心脏复律除颤器（ICD）有着悠久的历史，自20世纪80年代以来取得了显著进展。它们已成为预防心源性猝死的重要组成部分，在特定患者群体中已证实具有生存获益。然而，随着最近的试验以及当代心力衰竭治疗方法的引入，对于一级预防ICD的作用，尤其是在非缺血性病因所致心力衰竭患者中的作用，人们重新产生了兴趣并提出了新的问题。本综述回顾了ICD的历史和演变，评估了ICD的传统证据，并探讨了与患者选择、风险分层、竞争风险、未来方向以及拟议的当代ICD决策框架相关的问题。
