避免ICD不恰当治临床研究进展.pptVIP

MADIT-RIT临床研究 Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy (MADIT-RIT) 多中心ICD试验 – 减少不恰当治疗 背景：ICD不恰当治疗的比例较高，文献报道可高达30%~50%。 目的：在ICD和CRT-D一级预防的患者中，评价通过程控提高ICD的检测频率及延长持续时间对不恰当治疗的影响。 设计：前瞻性；随机，单盲，平行对照 样本量：1500 终点 主要终点：第一次不恰当治疗的时间 二级终点：全因死亡率，晕厥 随访时间：12个月 研究进展： 2009年9月开始入选患者 2011年10月入选结束 预计完成时间2012年下半年 MADIT-RIT临床研究 ICD临床研究新进展 如何减少ICD不恰当的放电? ALTITUDE REDUCES Study MADIT RIT 如何避免ICD噪音干扰? ALTITUDE NOISE Study * * Wyatt Stahl in CRM Marketing are the source of the information presented at HRS 2009 During the AHP Wasted Energy Presentation. Phase II Sick Sinus Part II * The ALTITUDE project is an independent clinical science initiative that launched in 2008 and was formed to prospectively analyze data from implanted ICD and CRT devices manufactured by Boston Scientific Corporation (Natick, Mass) that regularly communicate information over a network from patients’ homes. The remote monitoring system, known as LATITUDE, gained Food and Drug Administration approval in 2005 and was market released in 2006 for CRT-D and then ICD devices. CRT-only devices do not yet have * * * * The purpose of this panel is to: Provide scientific and clinical guidance regarding the use of certain LATITUDE data Develop and refine research questions Guide manuscript development and abstract publications Publish and present * * * * * * * * * * * Figure 3. Percent of all shocks by rhythm type and detection rate. * * VF, Ventricular fibrillation; VT, ventricular tachycardia; SVT, supraventricular tachycardia. TABLE 16-3? ?--?Initial ICD Programming Recommendations for Primary and Secondary Prevention Devices* * For three major U.S. device manufacturers: Medtronic; St. Jude Medical; Boston Scientific; All three major U.S. manufacturers. ? Bursts are 88% of detected cycle length with 20-msec decrement between bursts (for 1 burst). ? SVT discriminators include morphology and stability.  Phase II Sick Sinus Part II * 定义 恰当治疗 ICD对血流动力学不稳定的单形性室速、多形性室速以