Manolis A S
Electrophysiology and Pacing Laboratory, Tufts/New England Medical Center, Tufts University School of Medicine, Boston, MA.
Arch Intern Med. 1994 Mar 28;154(6):617-22.
The development of nonthoracotomy lead systems for the implantable cardioverter defibrillator has ushered in a new era in the field of device therapy for malignant ventricular tachyarrhythmias. Surgical mortality and morbidity are thus significantly reduced, the hospital stay is shortened, and the cost of such therapy is lowered. Although several problems (mainly lead related) were initially encountered with earlier-generation systems, improvements have made this less invasive method of defibrillator therapy an attractive alternative to conventional epicardial implants. It is rapidly becoming a first-choice approach in the treatment of malignant ventricular tachyarrhythmias. Transvenous leads were used in combination with a subcutaneous patch for effective defibrillation in the majority of patients, according to most published reports, while the number of "transvenous only" systems being implanted has been steadily increasing. A description of currently available nonthoracotomy lead defibrillator systems and a discussion of the clinical results, advantages, and limitations of their use are presented herein.
植入式心脏复律除颤器非开胸导联系统的发展开创了恶性室性心律失常器械治疗领域的新纪元。手术死亡率和发病率因此显著降低，住院时间缩短，此类治疗的费用降低。尽管早期系统最初遇到了几个问题（主要与导联有关），但改进使这种侵入性较小的除颤器治疗方法成为传统心外膜植入的有吸引力的替代方案。它正迅速成为治疗恶性室性心律失常的首选方法。根据大多数已发表的报告，在大多数患者中，经静脉导联与皮下贴片联合使用以进行有效的除颤，而仅植入“经静脉”系统的数量一直在稳步增加。本文介绍了目前可用的非开胸导联除颤器系统，并讨论了其临床结果、优点和使用局限性。
