ICD在心脏性猝死中的应用.ppt

Your heart pumps blood to other organs in your body. The pumping action, or contractions, are coordinated by the heart’s own electrical circuit. This electrical system can malfunction causing an arrhythmia. Arrhythmias are very common and are defined as heart rates that are too slow, too fast or irregular. The vast majority of arrhythmias are harmless, but some can be serious. One rhythm that is very dangerous is ventricular fibrillation (VF). When the heart is in ventricular fibrillation it will stop beating effectively and stop pumping blood to the body. When this happens there is no blood pressure and no pulse. If this condition is not treated immediately, death will result within several minutes. A recent study of 15,041 post-MI patients (GUSTO-III) found 5.7% of the study patients had a VT or VF event within 48 hours of their MI event. The overall mortality rates of these patients were significantly higher than for patients who did not experience a VT or VF event, as shown above. This data also shows that if patients survive to hospital discharge their survival parallels that of patients without VT/VF. The AVID trial documented the rate of arrhythmic death over a three year period (8%, 11%, and 18%) in the non-ICD patients. It is important to note that many of these patients had left ventricular dysfunction, heart failure, and/or ischemic heart disease as the underlying cause for their SCA event. CHF increased sudden death and overall mortality during a 38 year old follow-up of subjects in the Framingham Heart Studt. The presence of congestive heart failure (CHF) significantly increased sudden death and overall mortality in both men and women. *P 0.01, ?P.001. Sudden cardiac deaths among young adults and children are most often caused by these genetic disorders. In HCM the magnitude of hypertrophy is directly related to the risk of sudden death and is strong independent predictor of prognosis. Over a mean follow-up of 6.5 years, 65 of 480 patients (15