ICD导线植入部位的选择对除颤成功率的影响PPT.ppt

ICD导线植入部位的选择对除颤成功率的影响;提纲;ICD导线的传统植入部位;除颤导线植入RVA的潜在危害;RV Non-Apical vs. Apical Pacing;A. 后前位;B. 左前斜30度;RVNA 优于RVA 血流动力学 减轻左室重构 保护心功能 安全角度：RVNA优于RVA？ RVNA能否保证良好的除颤效果？;保证除颤成功率的关键;RV Non-Apical vs. Apical Defibrillator Lead除颤成功率对比的相关研究;RV Non-Apical vs. Apical Defibrillator Lead除颤成功率对比的相关研究;2014年，Christof Kolb等, Safety of mid-septal electrode placement in implantable cardioverter defibrillator recipients — Results of the SPICE (Septal Positioning of ventricular ICD Electrodes) study, International Journal of Cardiology 2015年，Gerald C等，A comparison of right ventricular non-apical defibrillator lead position with traditional right ventricular apical position: a single centre experience 2016年，Amit G等， Apical vs. non-apical lead: is ICD lead position important for successful defibrillation?. J Cardiovasc Electrophysiol;Right ventricular outflow tract placement of defibrillation leads: five year experience2004年;Pacing threshold;A randomized comparison of defibrillation thresholds in the right ventricular outflow tract versus right ventricular apex2008年;A prospective randomized trial of defibrillation thresholds from the right ventricular outflow tract and the right ventricular apex 2009年;A prospective randomized trial of defibrillation thresholds from the right ventricular outflow tract and the right ventricular apex 2009年;Randomized comparison of defibrillation thresholds from the right ventricular apex and outflow tract2010年;纳入185例植入ICD的患者 153 male / 32 female 平均年龄67±10岁（28-82岁） 除颤电极经静脉置入RVOT或RVA;RVA组与RVOT组术中参数对比;纳入299例植入ICD的患者 79% male ，平均年龄65.2±12.1岁 83%一级预防 除颤电极随机置入中位间隔（n=145）或RVA（n=154）;一级终点：术后3个月的无事件生存率 二级终点：术后12个月的无事件生存率 事件包括：导线重置、右室电极参数不理想（包括DFT25J） ;;纳入512例植入ICD的患者 RVNA组平均随访40.4±25.9个月 RNA组平均随访38±31.8个月;Apical vs. non-apical lead: is ICD lead position important for successful defibrillation?2016年;;;;CRTD：除颤导线???入部位对除颤的影响;南京医科大学第一附属医院经验;小结;The end