缺血性和非缺血性心肌病心源性猝死的预防_T.Jared.ppt

Conflicts of Interest Boston Scientific: speakers honorarium 适于ICD预防心源性猝死的人群比例？OREGON SUD 研究 MADIT I 试验 心肌梗死患者植入ICD获益的时间依赖性 心肌梗死后心源性猝死 14,609 例 VALIANT 试验 心源性猝死 – 7% 心肌梗死合并左室功能不全者死亡的原因 SCD-HeFT 研究 DEFINITE 试验 （抗心律失常药治疗非缺血性心肌病的疗效评价） DEFINITE 试验 ICD用于一级预防的效果 MADIT-CRT 研究 RethinQ 研究 EF正常的心脏骤停 减少危险因子 有效治疗高脂血症 有效控制高血压 有益于心脏健康的饮食 有规律的体育锻炼 戒烟 适量饮酒 有效控制糖尿病 鱼肉或鱼油与猝死风险 根本在于基因 44 例 围产期 心肌病 12 NSVT/VT ICD适应症 ICD适应症 ICD适应症 Stratification of Risk and Prevention of Sudden Death in Hypertrophic Cardiomyopathy Conflicts of Interest Boston Scientific: speakers honorarium What Proportion Would Have Qualified for Prevention with ICD?OREGON SUD Study The Multicenter Automatic Defibrillator Implantation Trial (MADIT I) Time Dependence of ICD Benefit after MI Sudden Cardiac Death in Post MI Patients 14,609 pt VALIANT Trial SCD – 7% Causes of Death After MI with LV Dysfunction Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Trial Time Benefit of ICD therapy (DEFINITE Trial) Efficacy of ICD for Primary Prevention MADIT-CRT RethinQ Study Sudden Cardiac Arrest with Normal EF Risk Factor Reduction Effective treatment of hypercholesterolemia Effective treatment of hypertension Adoption of a heart-healthy diet Regular exercise Smoking cessation Moderation of alcohol consumption Effective treatment of diabetes The consumption of fish and fish oil sudden death risk All in the Genes 44 Patients Peripartum Cardiomyopathy 12 NSVT/VT Recommendations for ImplantableCardioverter-Defibrillators Recommendations for ImplantableCardioverter-Defibrillators Recommendations for ImplantableCardioverter-Defibrillators Stratification of Risk and Prevention of Sudden Death in Hypertrophic Cardiomyopathy Yaggi, H. et al. N Engl J Med 2005;353:2034-2041 Sudden Death with Obstructive Sleep Apnea Survival Years OSA Controls P=0.03 0 10 20 30 40 50 Day-Night Pattern of SCD Proportion of total s