ICD植入适应证指南及大型临床试验介绍课件.ppt

即使符合上述I、IIa和IIb类适应症，但预期寿命短于1年 无休止的室速或者室颤 有明显的精神疾病，可能被器械植入术加重，或是不能进行系统的随访 药物难以控制的心力衰竭，NYHA心功能IV，无条件进行心脏移植或CRT-D治疗 I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III All primary SCD prevention ICD recommendations apply only to patients who are receiving optimal medical therapy and have reasonable expectation of survival with good functional capacity for more than 1 year. ICD III 类治疗建议 原因不明的昏厥，即没有可诱发的室性快速心律失常也不合并器质性心脏病 合并沃尔夫-帕金森-怀特综合症引起的房性心率失常、右室或左室流出道性室速，特发性室速，无器质性心脏病分支相关性室速 ， 经手术或导管消融术可以治愈者 无器质性心脏病，由完全可逆原因导致的室性快速型心律失常（如电解质紊乱，药物，外伤） I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III I I I IIa IIa IIa IIb IIb IIb III III III IIa IIa IIa IIb IIb IIb III III III All primary SCD prevention ICD recommendations apply only to patients who are receiving optimal medical therapy and have reasonable expectation of survival with good functional capacity for more than 1 year. ICD III 类治疗建议 * * Major milestones in ICD therapy evolution include: 1985: First FDA approval of basic implantable defibrillator. Implants are reserved