室性心律失常的icd治疗心脏性猝死（scd）一级二级预防课件

1、达尼哈尔克(1983-2009)南非世界杯他们的猝然离世为人们敲响了警钟：他们的猝然离世为人们敲响了警钟：小心小心“心脏性猝死心脏性猝死”！* 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.心脏性骤停致死亡人数心脏性骤停致死亡人数（美国（美国/年）年）范围范围：166,200310,0001020304050607080901000123456789每分钟减少成功机会每分钟减少成功机会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、二级预防一、二级预防比较比较 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注册注册登记标准登记标准,Link研究研究1MADITSCD-HeFT MADIT II由由IIa成为成为I类类MUSTT 60岁，男性；著名的政治活动家，1978年第1次出现心肌梗死，在1984年至2001年3月中有3次不同程度的冠心病，心肌梗死发生，在此期间接受了两次冠状动脉扩张手术以改善冠状动脉堵塞状况， 2001年6月，Holter记录发现2秒多的135BPM