icd植入术后年内无是否需要更换?反方.pptVIP

icd植入术后年内无是否需要更换?反方.ppt

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* Overall, survival at one and two years was 89.3% and 81.6%, respectively, in the ICD treated patients, and 82.3% and 74.7% in AAD treated patients. For patients with an LVEF 0.20, the survival rate was 82.4% and 71.6% at one and two years in the ICD treated patients, respectively, and 73.0% and 63.8% in the AAD treated patients. In patients with an LVEF between 0.20 and 0.34, the overall survival rate was 82.9% and 82.5% at one and two years, respectively, in the ICD treated patients and 79.8% and 71.8% in the AAD treated patients. In patients with an LVEF 0.34, there was no difference in survival between AAD treated patients and ICD treated patients. For patients with an LVEF between 0.20 and 0.34, there was statistically improved survival with an ICD as compared with AAD therapy (p0.05). In the smaller subgroup with an LVEF 0.20, the same magnitude of survival difference was seen as in the 0.20 to 0.34 LVEF group, but that difference did not reach statistical significance. 3Domanski MJ, Saksena S, Epstein AE, et al. Relative Effectiveness of the Implantable Cardioverter-Defibrillator and Antiarrhythmic Drugs in Patients With Varying Degrees of Left Ventricular Dysfunction Who Have Survived Malignant Ventricular Tachyarrhythmias. J Am Coll Cardiol. 1999;34:1090-1095. * The MADIT-II study showed a 31% statistically significant reduction in overall mortality with ICD therapy compared to conventional therapy at the end of study follow-up. The absolute mortality benefit was 5.6%. 所有具统计学意义的ICD临床试验中绝对好处最小的临床试验,可能与较高的B受体阻滞剂的使用(70%)和较低的胺碘酮的使用(13%在ICD组对10%在对照组)有关 * Besides the increase in CHF hospitalization, there were no other unexpected adverse outcomes with ICD therapy. * In the MADIT II study, the mortality rate of patients receiving therapy for VF was over 50%at 2 years. Eleven percent of patients in the SCD-HeFT trial who received a single shock died within 24H, and the average life expectancy thereafter was 1 year.(Heart Rhythm 2006;3:S40.) * 一级和二级预防临床试验均显示

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