ICD交流课件：Shock Reduction-20120625-Robin已阅.pptVIP

* Two hundred twenty patients with CAD and standard indications for ICD therapy were enrolled at 25 centers from April 1998 through November 1999. All patients underwent implantation of pectoral ICD systems with a transvenous endocardial lead positioned at the right ventricular apex. Each patient was followed up for 6 to 12 months, CAD : coronary artery disease * Figure 1. Summary of ventricular arrhythmias detected and therapy sequence for FVT. *By protocol, Rx1 included 2 sequences of burst ATP. Therapy sequence between ATP failure and 1-shock success unknown because of numerous episodes exceeding device memory capability. 华：PII只设一个ATP，PI2个ATP，可能与减少晕厥有关 * * 4-7%加速比例与在传统VT检测区中VT的ATP研究相同 2% 晕厥比例与其他ICD的研究相同 * PAINFREE Rx and PainFREE Rx II STUDY DETAILS _______________________________________________________________ PainFREE Rx Study Overview: Much of what we detect as “VF” is really pace-terminable fast VT. Objective of the study was to determine whether spontaneous FVT (CL 240 to 320 ms, 188 to 250 bpm) in patients with coronary artery disease (CAD) can be reliably and safely terminated by ATP, thus reducing painful shocks. ? Hypothesis: ATP may reduce shock therapy for rapid VT without significant increase in acceleration or syncope. ? PainFREE Study Details: 220 patients, 25 U.S. centers, Single-Blinded, Enrollment dates: 4/1998 to 11/1999, GEM? Family ICDs, 75% Dual Chamber ICDs PainFREE Study Conclusions: A single empirical ATP attempt terminated 77% of FVT ATP did not increase negative outcomes. _______________________________________________________________________________________ PainFREE Rx II Study Overview: PainFREE Rx II (PF2) was a randomized study comparing ATP shocks that included all comers ATP reduced 3 out of 4 shocks ATP did not increase negative outcomes PainFREE (PF) programming improved patient Quality of Life Only Medtronic ICDs are clinically proven to reduce shocks with PF programming ? PainFREE Rx II Study Details: 634