Pinski S L, Fahy G J
Department of Cardiology, Cleveland Clinic Foundation, OH, USA.
Circulation. 1995 Sep 15;92(6):1651-64. doi: 10.1161/01.cir.92.6.1651.
The implantable cardioverter-defibrillator (ICD) is remarkably effective in preventing sudden cardiac death in high-risk patients, but it also has the capacity to provoke or worsen cardiac arrhythmias. Tachyarrhythmias or bradyarrhythmias may result from the delivery of antitachycardia or antibradycardia therapies by tiered-therapy defibrillators. This proarrhythmia, although rarely fatal, increases the morbidity associated with defibrillator therapy. Proarrhythmia is related as much to suboptimal programming as to technical limitations of the device. The proarrhythmic potential of ICD therapy can be minimized by tailoring the "electrical prescription" according to characteristics of the clinical arrhythmia and individual ICD idiosyncrasies.
植入式心脏复律除颤器（ICD）在预防高危患者心源性猝死方面非常有效，但它也有引发或加重心律失常的可能。分层治疗除颤器进行抗心动过速或抗心动过缓治疗时，可能会导致快速性心律失常或缓慢性心律失常。这种致心律失常作用尽管很少致命，但会增加与除颤器治疗相关的发病率。致心律失常作用既与编程欠佳有关，也与设备的技术限制有关。根据临床心律失常的特征和个体ICD的特质调整“电处方”，可将ICD治疗的致心律失常可能性降至最低。
