Implantable Cardioverter-Defibrillators

作者：Zachary D. Goldberger, Rachel J. Lampert · 发表于：JAMA · 年份：2006 · DOI：10.1001/jama.295.7.809 · 被引用次数：275 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac electrophysiology and arrhythmias、Neurological disorders and treatments

CONTEXT: Sudden cardiac death (SCD) is a major challenge facing contemporary cardiology. For an increasing number of patients, the current standard of care for the treatment and prevention of SCD is the implantable cardioverter-defibrillator (ICD). Since its introduction, there have been numerous advances in ICD technology, and indications for its use have expanded greatly in the past year. OBJECTIVE: To highlight the evolving indications for and the numerous advances in ICD technology, with emphasis on primary and secondary prophylaxis of SCD. EVIDENCE ACQUISITION: Electronic literature search of the Pubmed and MEDLINE databases from January 1996 to July 2005, using the Medical Subject Heading implantable defibrillator. Abstracts and titles were reviewed to identify English-language randomized controlled trials that included an ICD group and a non-ICD group and that had end points of all-cause mortality, cardiac death, and/or arrhythmic mortality as the main outcome. A further MEDLINE search was conducted to identify randomized controlled trials of cardiac resynchronization therapy (CRT) with a CRT and a non-CRT group (including both mortality and other end points). Other studies were included that clarify aspects of device function and other relevant issues. A total of 22 trials were identified. EVIDENCE SYNTHESIS: ICD implantation improves survival in patients with a history of life-threatening ventricular arrhythmia. More recent evidence shows that ICD implantation also i...