心肌梗死后的心室刺激

B. Brembilla-Perrot
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引用次数: 0

摘要

PVS是筛查室性心动过速(VT)和室性相关猝死风险患者的主要技术(1-3)。在此期间,自植入式心律转复除颤器(ICD)以来,PVS被认为不利于冠心病的风险分层:许多具有里程碑意义的试验表明,预防性ICD植入术对只有低左室射血分数(LVEF)的患者有益(4,5)。目前,指南推荐有心肌梗死(MI)病史(大于6周)且LVEF低于30%的患者系统植入ICD(6)。然而,有报道称ICD的促心律失常作用及其他并发症(7-9)。此外,诱导性室性心动过速仍然是心脏死亡的一个重要而独立的因素(10)。
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Ventricular Stimulation After Myocardial Infarction
lation (PVS) was a major technique of screening patients at risk for ventricular tachycardia (VT) and VT–related sudden death (1-3). During this time PVS was not considered advantageous for risk stratification in coronary heart disease since implantable cardioverter defibrillators (ICD): a number of landmark trials have shown a benefit of prophylactic ICD implantation in patients with only low left ventricular ejection fraction (LVEF) (4,5). Now, the guidelines recommend the systematic implantation of ICD in patients with history of myocardial infarction (MI) (more than 6 weeks) and LVEF lower than 30% (6). However, proarrhythmic effect of ICD and other complications were reported (7-9). More, inducible VT remains an important and independent factor of cardiac mortality (10).
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