Groh W J, Foreman L D, Zipes D P
Indiana University School of Medicine, Indianapolis, USA.
Am Fam Physician. 1998 Jan 15;57(2):297-307, 310-2.
Implantable cardioverter-defibrillators are commonly used in patients who have life-threatening ventricular arrhythmias. With these implanted electronic devices, bradyarrhythmias and tachyarrhythmias can be recognized promptly and treated with electrical pacing, cardioversion or defibrillation. Implantable cardioverter-defibrillators have been shown to substantially reduce the incidence of sudden cardiac death in patients with known life-threatening ventricular arrhythmias. Their role in the primary prevention of sudden cardiac death in patients at high risk for ventricular arrhythmias is being evaluated. Technologic advances have allowed transvenous implantation of cardiac leads, obviating the need for open heart surgery and thereby lowering the risk of perioperative morbidity and mortality. Most electrical therapies are triggered appropriately to treat ventricular tachycardia/fibrillation. Inappropriate discharges may occur secondary to supraventricular causes of tachycardia, environmental interference from electromagnetic devices or malfunction of the cardioverter-defibrillator. All episodes of discharge merit investigation. With recurrent or frequent discharges, prompt evaluation and hospitalization are often necessary.
植入式心脏复律除颤器常用于患有危及生命的室性心律失常的患者。借助这些植入式电子设备，可迅速识别缓慢性心律失常和快速性心律失常，并通过电起搏、心脏复律或除颤进行治疗。已证明植入式心脏复律除颤器可大幅降低已知患有危及生命的室性心律失常患者的心源性猝死发生率。它们在室性心律失常高危患者心源性猝死一级预防中的作用正在评估中。技术进步使得经静脉植入心脏导线成为可能，无需进行心脏直视手术，从而降低了围手术期发病和死亡风险。大多数电疗法能被适当地触发以治疗室性心动过速/心室颤动。不适当的放电可能继发于室上性心动过速原因、电磁设备的环境干扰或心脏复律除颤器故障。所有放电事件都值得调查。对于反复或频繁放电，通常需要及时评估和住院治疗。
