【醫(yī)學課件】室性心律失常：成功與失敗ppt課件-預(yù)覽頁
【正文】 e of Structural Heart Disease ? If antiarrhythmic drugs are necessary: – Class 1C: ? Flecainide. ? Propafenone. – Mexilitene. – Amiodarone is rarely, if ever, indicated. Management of Ventricular Ectopy in the Presence of Structural Heart Disease AVID ? Antiarrhythmics Versus Implantable Defibrillators ? Sponsored by: – National Institutes of Health ? Entry Criteria: – VF – VT with syncope – VT without syncope, with EF .40, and SBP 80mm Hg, chest pain, CHF, or near syncope ? Treatment: – ICD vs. empiric amiodarone or Holter/EPguided sotalol ? Primary endpoint: – Total mortality AVID Investigators. N Engl J Med. 1997。335:19331940. MADIT Inclusion Criteria ? Prior Qwave MI ? Nonsustained VT ? EF 35% ? Inducible, nonsuppressible VT ? NYHA Class I – III ? Age 25 80 ? 3 weeks from last MI ? No requirement for revascularization Moss AJ. N Engl J Med. 1996。341:188290. MUSTT Hypothesis Antiarrhythmic (AA) therapy guided by EP testing can reduce the risk of arrhythmic death and cardiac arrest in patients with: ? CAD ? EF ? Asymptomatic nonsustained VT ( 3 beats, 30 sec, rate 100 bpm) Buxton AE. N Engl J Med. 1999。 223。341:188290. MUSTT Conclusions For CAD patients with EF .40, asymptomatic NSVT and inducible VT: ? ICD therapy significantly reduces the incidence of: 1
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