Jordaens L J
Vakgroep Inwendige Ziekten, Dienst Hart-en Vaatziekten, Universiteit Gent.
Verh K Acad Geneeskd Belg. 1997;59(2):107-33.
Interventional techniques in clinical cardiology became important in rhythmology, because it is evident that antiarrhythmic drug therapy has several limitations, and side effects. The implantable cardioverter defibrillator is a very reliable tool in the therapy of ventricular fibrillation and ventricular tachycardia. Conversion of these arrhythmias is associated with the prevention of subsequent sudden cardiac death in patients who received implantation after cardiac arrest, not associated with myocardial infarction or metabolic disturbances. The exact place of the defibrillator in the treatment of ventricular tachycardia remains unsettled, as amiodarone, sotalol and catheter ablation are acceptable treatment modalities for some patients. Furthermore, associated antiarrhythmic drug therapy remains necessary in a large group of patients after implantation. The morbidity and mortality of the recently developed non-thoracotomy devices is low. The potential value of implantable defibrillators in the prevention of cardiac arrest in high-risk patients remains to be studied.
临床心脏病学中的介入技术在心律失常学中变得重要起来,因为抗心律失常药物治疗存在明显的局限性和副作用。植入式心脏复律除颤器是治疗心室颤动和室性心动过速的非常可靠的工具。这些心律失常的转复与预防心脏骤停后接受植入的患者随后发生的心源性猝死相关,与心肌梗死或代谢紊乱无关。除颤器在室性心动过速治疗中的确切地位仍未确定,因为胺碘酮、索他洛尔和导管消融对一些患者来说是可接受的治疗方式。此外,在大量植入后的患者中,联合抗心律失常药物治疗仍然是必要的。最近开发的非开胸设备的发病率和死亡率较低。植入式除颤器在预防高危患者心脏骤停方面的潜在价值仍有待研究。