全皮下埋藏式心脏复律除颤器的临床应用进展  

Research on the progress in clinical application of subcutaneous implantable cardioverter defibrillator

作　　者：刘晨(综述) 关淇帆 牛国栋 郭雨龙 郭涛(审校) LIU Chen;GUAN Qifan;NIU Guodong;GUO Yulong;GUO Tao(Arrthythmia Center,Fuwai Yunnan Cardiovascular Hospital,kunming Yunnan 650102,China)

机构地区：[1]云南省阜外心血管病医院心律失常中心,云南昆明650102

出　　处：《云南医药》2024年第3期71-74,共4页Medicine and Pharmacy of Yunnan

基　　金：云南省教育厅科学研究基金项目(2019J1302),云南省阜外心血管病医院院级科研基金项目(2019YFKT-09)。

摘　　要：埋置式ICD是救治SCD最有效方法,已被证明在治疗危及生命的VT/VF方面优于药物,可显著降低SCD高危患者的死亡率。但传统ICD(T-ICD)需经静脉植入心内感知、起搏、除颤电极导线,与心内导线相关的血气胸、心脏穿孔、心脏压塞、电极移位、电极损毁、三尖瓣反流、导线拔除困难等并发症,因并发症增多必然会导致住院时间延长,医疗费用增加,甚至导致死亡率升高,会对预后产生严重影响。为克服上述缺陷而问世的全皮下埋藏式ICD(S-ICD)不仅具备救治VT/VF的功能,还弥补了T-ICD的不足,已经在国内外广泛应用,本文复习文献,讨论S-ICD的应用进展。The implantable cardioverter defibrillator(ICD)is the most effective method for rescuing sudden cardiac death(SCD)and has been shown to be superior to medical therapy for life-threatening ventricular tachycardia(VT/VF),significantly reducing mortality in patients at high risk of SCD.However,traditional ICD(t-icd)requires intravenous implantation of intracardiac sensing,pacing and defibrillation electrode leads.The complications related to intracardiac leads,such as hemopneumothorax,cardiac perforation,cardiac tamponade,electrode displacement,electrode damage,tricuspid regurgitation and difficult lead extraction,will inevitably lead to prolonged hospital stay,increased medical expenses,and even increased mortality,which will have a serious impact on the prognosis.The all subcutaneous buried s-icd developed to overcome the above defects not only performs the function of rescuing VT/VF,but also compensates the shortage of T-ICD,which has been widely used at home and abroad,this article reviews the literature and discusses the progress of S-ICD application.

关 键 词：T-ICD S-ICD 安全性 有效性 

分 类 号：R541.7[医药卫生—心血管疾病]