icd电风暴的参数优化

icd电风暴的参数优化内容摘要：

ICD to inhibit sensing and treatment of the arrhythmia.  If the patient develops a ventricular arrhythmia, removing the mag enables the delivery of therapy. Applying a mag does not alter the pacing ability of the ICD. + Electrical Storm in ICD Patients 3  Shocks from ICDs have adverse effects. Among patients with heart failure who receive an ICD for primary prevention, those who receive shocks for arrhythmia have a higher mortality rate than do patients who receive no shocks.  Not only are the shocks painful and distressing to patients, but repeated shocks can cause depression and posttraumatic stress syndrome, and they have been associated with phantom shocks.  Patients require reassurance if they report a shock but interrogation of the device reveals that no therapy was delivered.  At 1year followup evaluation, amiodarone plus a β blocker had most effectively reduced the number of shocks. The shock rate was % in the amiodarone plus β blocker group, % in the sotalol group, and % in the β blocker group. + 可进行优化的参数  Cutoff Rates and Detection Zones  Detection Time/Beats  SVT Discriminators  Timers to Override Discriminators  Oversensing  Antitachycardia Pacing (ATP) J Cardiovasc Electrophysiol, Vol. 22, pp. 10301033, September 2020. PainFREE Rx II 室性心律失常分布 FVT可快至240ms* * PainFREE RX II study ATP 成功 229/284 72% ATP失败 49/284 28% • percentages GEE adjusted for patients with multiple episodes • details on %ATP success by cycle length available under supplement PainFREE RxII FVTs在 ATP组的结果 1） Empiric 组程控设置 1,2,4 Zone Detection Interval/Rate Beats to Detect Therapies VF On 300 ms ( 200 bpm) 18 of 24 30 J x 6 FVT Via VF 240 ms (201 – 250 bpm) NA Burst (1), 30 J x 5 VT On ≥ 400ms (≤ 150 – 200 bpm) 16 Burst (2), Ramp (1), 20J, 30 J x 3 2）医生个体化程控设置 ： 根据医生自身判断 两组在 1年随访过程中均可根据治疗需要做调整 Wilkoff BL, et al,Heart Rhythm Society 2020。 2:10341037. Sterns LD, et al, Heart Rhythm. 2020。 2(1S):S126. M。