icd電風(fēng)暴的參數(shù)優(yōu)化-全文預(yù)覽
【正文】 n cause depression and posttraumatic stress syndrome, and they have been associated with phantom shocks. ? Patients require reassurance if they report a shock but interrogation of the device reveals that no therapy was delivered. ? At 1year followup evaluation, amiodarone plus a β blocker had most effectively reduced the number of shocks. The shock rate was % in the amiodarone plus β blocker group, % in the sotalol group, and % in the β blocker group. + 可進(jìn)行優(yōu)化的參數(shù) ? Cutoff Rates and Detection Zones ? Detection Time/Beats ? SVT Discriminators ? Timers to Override Discriminators ? Oversensing ? Antitachycardia Pacing (ATP) J Cardiovasc Electrophysiol, Vol. 22, pp. 10301033, September 2020. PainFREE Rx II 室性心律失常分布 FVT可快至240ms* * PainFREE RX II study ATP 成功 229/284 72% ATP失敗 49/284 28% ? percentages GEE adjusted for patients with multiple episodes ? details on %ATP success by cycle length available under supplement PainFREE RxII FVTs在 ATP組的結(jié)果 1） Empiric 組程控設(shè)置 1,2,4 Zone Detection Interval/Rate Beats to Detect Therapies VF On 300 ms ( 200 bpm) 18 of 24 30 J x 6 FVT Via VF 240 ms (201 – 250 bpm) NA Burst (1), 30 J x 5 VT On ≥ 400ms (≤ 150 – 200 bpm) 16 Burst (2), Ramp (1), 20J, 30 J x 3 2）醫(yī)生個(gè)體化程控設(shè)置 ： 根據(jù)醫(yī)生自身判斷 兩組在 1年隨訪過程中均可根據(jù)治療需要做調(diào)整 Wilkoff BL, et al,Heart Rhythm Society 2020。ICD電風(fēng)暴的參數(shù)優(yōu)化 解放軍總醫(yī)院 解放軍醫(yī)學(xué)院 王玉堂 ICD電風(fēng)暴 (Electrical Storm ES) ● 頻繁、反復(fù)發(fā)生的 VT和 /或不穩(wěn)定 VT ● 24h內(nèi) 3次 VT/VF事件接受恰當(dāng)?shù)碾姄糁委? ● 24h內(nèi) 3次 VT/VF事件接受恰當(dāng)?shù)闹委煟?ATP或電擊） 24小 時(shí) 之內(nèi) 發(fā) 生 ≥2次互不相 連 需 ICD干 預(yù) 室速或室 顫 事件 Circulation 1996。97:38992 Eur Heart J 2020。2:10341037. 19 PREPARE 程控策略 11 150 bpm 182 bpm 167 bpm J Am Coll Cardiol. August 12,2020。 PainFree SST 研究是用來(lái)證實(shí) Protecta 新的識(shí)別算法和特有設(shè)置能否減少不恰當(dāng)電擊發(fā)生率 . 一年無(wú)不恰當(dāng)電擊率為 % 不恰當(dāng)電擊率： 26 PainFree SST Trial Primary Results % 減少 %不恰當(dāng)治療 (ATP or Shock) 27 PainFree SST Trial Primary Results 1 Volosin JCE 2020 臨床研究結(jié)果證實(shí)了計(jì)算機(jī)模擬的結(jié)果 1 28 接受不恰
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