Raitt M H, Bardy G H
University of Washington School of Medicine, Seattle.
Curr Opin Cardiol. 1994 Jan;9(1):23-9. doi: 10.1097/00001573-199401000-00004.
The use of implantable defibrillation systems in patients with cardiac arrest has resulted in lower mortality than expected from studies of similar patients not receiving defibrillators. Nonthoracotomy lead systems have led to a decrease in operative mortality and lowered the cost of defibrillator implantation, but these systems have a higher energy requirement for defibrillation than do epicardial ones. The recent introduction of single-lead systems and bipolar defibrillation pulses has simplified nonthoracotomy defibrillator implantation and improved defibrillation efficiency. A prototype unipolar, single-lead pectoral implant defibrillation system is described that may significantly improve the reliability, safety, and cost effectiveness of nonthoracotomy defibrillators. This and other improved nonthoracotomy systems may expand the indications for defibrillator implantation to prophylactic use in high-risk patients who have not yet experienced life-threatening ventricular arrhythmias.
在心脏骤停患者中使用植入式除颤系统，其死亡率低于对未接受除颤器的类似患者进行研究所预期的死亡率。非开胸导联系统降低了手术死亡率，并降低了除颤器植入成本，但这些系统除颤所需能量比心外膜系统更高。最近推出的单导联系统和双极除颤脉冲简化了非开胸除颤器植入过程，并提高了除颤效率。本文描述了一种原型单极、单导联胸壁植入式除颤系统，该系统可能显著提高非开胸除颤器的可靠性、安全性和成本效益。这种及其他改进的非开胸系统可能会扩大除颤器植入的适应证，将其用于尚未经历危及生命的室性心律失常的高危患者的预防性使用。
