室性心律失常的icd治療心臟性猝死（scd）一級(jí)二級(jí)預(yù)防課件

1、達(dá)尼哈爾克(1983-2009)南非世界杯他們的猝然離世為人們敲響了警鐘：他們的猝然離世為人們敲響了警鐘：小心小心“心臟性猝死心臟性猝死”！* Range: 166,200 to 310,0001 Vital Statistics of the U.S., Data Warehouse, National Center for Health Statistics. 4 Department of Health and Human Services. Centers for Disease Control and Prevention.2 Chugh SS, et al. J Am Coll C

2、ardiol. 2004;44:1268-1275. 5 Avert Organization: 3 Nichol G, et al. JAMA. 2008;300:1423-1431. 6 2008 Heart and Stroke Statistics Update. American Heart Association.心臟性驟停致死亡人數(shù)心臟性驟停致死亡人數(shù)（美國(guó)（美國(guó)/年）年）范圍范圍：166,200310,0001020304050607080901000123456789每分鐘減少成功機(jī)會(huì)每分鐘減少成功機(jī)會(huì)7 - 10% % Success*Non-linear JACC 200

3、6;48(5):e247-346 in Chinese (permitted by Dr. Zipes and Journal of American College of Cardiology）JACC 2006;48(5):e247-346 in Chinese (permitted by Dr. Zipes and Journal of American College of Cardiology）1 Priori SG.et al.Task Force on Sudden Cardiac Death of the European Society of Cardiology.Europ

4、ean Heart Journal.2001;22:1374-1450.2 Maron BJ,et al.Efficacy of implantable cardioverter defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy.N Engl J Med.2004;342:363-3731,235% Mortality Reduction w/ ICD Rx42336553164567362020406080SCD-HeFTCOMPANIONMUSTTMA

5、DIT-IIOverall DeathArrhythmic Death1Bardy GH, et al. N Engl J Med. 2005;352:225-237.2 Packer DL. Heart Rhythm. 2005;2:S38-S393 Bristow MR, et al. N Engl J Med. 2004;350:2140-2150. 4 Buxton AE, et al. N Engl J Med. 1999;341:1882-1890. 5 Moss AJ, et al. N Engl J Med. 2002;346:877-883. 1 Moss AJ. N Eng

6、l J Med. 1996;335:1933-40.2 Buxton AE. N Engl J Med. 1999;341:1882-90.3 Moss AJ. N Engl J Med. 2002;346:877-834 Moss AJ. Presented before ACC 51st Annual Scientific Sessions, Late Breaking Clinical Trials, March 19, 2002.5 The AVID Investigators. N Engl J Med. 1997;337:1576-83.6 Kuck K. Circ. 2000;1

7、02:748-54.7 Connolly S. Circ. 2000:101:1297-1302.13, 42576ICD/CRT-D 一、二級(jí)預(yù)防一、二級(jí)預(yù)防比較比較 54%75%55%76%31%61%27 months39 months20 months31%56%28%59%20%33% Mortality Reduction w/ ICD Rx% Mortality Reduction w/ ICD Rx3 Years3 Years3 YearsAVIDCASHCIDSCIDS和和AVID注冊(cè)注冊(cè)登記標(biāo)準(zhǔn)登記標(biāo)準(zhǔn),Link研究研究1MADITSCD-HeFT MADIT II由由IIa成為成為I類類MUSTT 60歲，男性；著名的政治活動(dòng)家，1978年第1次出現(xiàn)心肌梗死，在1984年至2001年3月中有3次不同程度的冠心病，心肌梗死發(fā)生，在此期間接受了兩次冠狀動(dòng)脈擴(kuò)張手術(shù)以改善冠狀動(dòng)脈堵塞狀況， 2001年6月，Holter記錄發(fā)現(xiàn)2秒多的135BPM