Wietholt D, Block M, Isbruch F, Böcker D, Hammel D, Borggrefe M, Scheld H H, Breithardt G
Medizinische Klinik und Poliklinik, Innere Medizin C, Kardiologie und Angiologie, Westfälische Wilhelms-Universität Münster.
Z Kardiol. 1993 Mar;82(3):150-61.
Technical improvements of third generation implantable cardioverter defibrillators (ICD) like antitachycardia pacing modalities lead to an extended use of ICDs, not only in patients with aborted sudden cardiac death, but also in patients with hemodynamically tolerable ventricular tachycardia. In addition, anticipated results of current prospective studies might indicate the prophylactic use of ICDs in patients with high risk for sudden cardiac death, but without documented ventricular tachyarrhythmias. This report reviews mortality and complications associated with the ICDs with epicardial defibrillation leads. Mortality is separated in cardiac death, sudden cardiac, arrhythmogenic "not so sudden" cardiac death, and overall mortality. Pulmonary complications and infections are related to the underlying disease and the surgical procedure. Device- and lead-related complications, high defibrillation thresholds, pacemaker interactions, inappropriate shocks, arrhythmic effects, syncope, and psychosocial problems are reported, respectively.
第三代植入式心脏复律除颤器（ICD）的技术改进，如抗心动过速起搏模式，使得ICD的应用范围得以扩大，不仅用于心脏性猝死复苏成功的患者，也用于血流动力学耐受的室性心动过速患者。此外，当前前瞻性研究的预期结果可能表明，对于有心脏性猝死高风险但无记录的室性快速性心律失常的患者，可预防性使用ICD。本报告回顾了与采用心外膜除颤导线的ICD相关的死亡率和并发症。死亡率分为心源性死亡、心脏性猝死、心律失常性“并非如此突然”的心源性死亡以及总死亡率。肺部并发症和感染与基础疾病及手术操作有关。分别报告了与设备和导线相关的并发症、高除颤阈值、起搏器相互作用、不适当电击、心律失常效应、晕厥以及心理社会问题。
