Dougherty A H
Division of Cardiology, University of Texas at Houston 77030, USA.
Curr Opin Cardiol. 1996 Jan;11(1):2-8. doi: 10.1097/00001573-199601000-00002.
Despite the efficacy of implantable cardioverter-defibrillators in preventing sudden death associated with ventricular arrhythmias, 40% to 70% of patients with an implantable cardioverter-defibrillator receive adjunctive antiarrhythmic drug therapy. The most common aims of drug therapy are to reduce the frequency of ventricular tachycardia and fibrillation triggering shock, to alter the tachycardia characteristics in order to enhance the efficacy of antitachycardia pacing, and to suppress supraventricular tachyarrhythmias. Antiarrhythmic drugs may, however, interfere with implantable cardioverter-defibrillator function by raising defibrillation and pacing thresholds. Furthermore, drugs may adversely affect the sensing of ventricular tachycardia and fibrillation by the implantable cardioverter defribillator. Careful prescription and follow-up electrophysiologic testing is critical in ensuring a cooperative effect of drug and implantable cardiovascular-defibrillator after initiation of new therapy.
尽管植入式心脏复律除颤器在预防与室性心律失常相关的猝死方面具有疗效，但40%至70%植入了植入式心脏复律除颤器的患者接受辅助抗心律失常药物治疗。药物治疗最常见的目的是减少触发电击的室性心动过速和颤动的频率，改变心动过速的特征以提高抗心动过速起搏的疗效，并抑制室上性快速心律失常。然而，抗心律失常药物可能会通过提高除颤和起搏阈值来干扰植入式心脏复律除颤器的功能。此外，药物可能会对植入式心脏复律除颤器对室性心动过速和颤动的感知产生不利影响。在开始新治疗后，谨慎的处方和后续电生理测试对于确保药物与植入式心脏复律除颤器的协同作用至关重要。
