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J Med. September 4, 2022。ICD術(shù)后電擊管理 ——美敦力 ICD術(shù)后電擊管理 周淑嫻 中山大學(xué)孫逸仙紀念醫(yī)院 南方醫(yī)科大學(xué)附屬南方醫(yī)院 黃曉波 高達 21%的 ICD患者會發(fā)生不恰當(dāng)?shù)碾姄? 1 Kadish A, Dyer A, Daubert JP, et al, for the Defibrillators in NonIschemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. May 20, 2022。350(21):21512158. 2 Daubert JP, Zareba W, Cannom DS, et al, for the MADIT II Investigators. Inappropriate implantable cardioverterdefibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact. J Am Coll Cardiol. April 8, 2022。359(10):10091017. 4 Mitka M. New study supports lifesaving benefits of implantable defibrillation devices. JAMA. July 8, 2022。110(17):25912596. 2 Sweeney MO, et al. Differences in effects of electrical therapy type on health care utilization in the MVP ICD Trial. HRS, 2022. 引起電擊的原因 4 Poole JE, et al. Heart Rhythm Society. 2022. SCD HeFT sample episode Poole JE, Johnson GW, Hellkamp AS, et al. Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med. September 4, 2022。 RV ATP ? Oversensing/Artifact T波識別 可程控的 RV感知環(huán)路 導(dǎo)線完整性報組合警 智能電擊技術(shù)SmartShock ?ATP During Charging ? 組合 減少不必要的電擊治療 ?特有的多位點 ATP(Biv, Lv, Rv)提高無痛治療成功率 Detection nn ATP Confirmation/Synchronization Episode termination occurs after 8 long cycles Capacitor Charging ATP During Charging with ATP Success ? 最大限度減少不必要的電擊治療 ? 若 ATP無效,不延誤電擊治療的發(fā)放 優(yōu)化的 ATP無痛治療減少 不必要 的電擊 ?ATP During Charging ? 組合減少不必要的電擊治療 ?特有的 多位點 ATP(Biv, Lv, Rv)提高無痛治療成功率 BIVATP在 室速區(qū) 的成功率高達 89%,在 慢室速區(qū) 的成功率 100%,而傳統(tǒng)的 RVATP分別為 72%和 74%,且加速和暈厥的風(fēng)險更高! Efficacy and safety of di