课件：基本SCD的预防和ICD适应症指导.ppt

5.明显的精神性疾病，可能被器械植入术所加重，或是不能进行系统的随访（C） 6.预期生存期6个月的终末期疾病（C） 7.有左室功能障碍和QRS时限延长而无自发的或可诱发的持续性或非持续性室速的、准备进行紧急冠状动脉旁路手术的冠心病患者（B） 8.NYHA分级IV级的、非等候心脏移植术的药物难治性充血性心力衰竭患者（C） ICD治疗的适应证 III类 谢 谢 ! THANK YOU SUCCESS * * 可编辑 Sudden cardiac death is the 2nd leading cause of death after all cancers combined. Death from cardiac causes accounted for 30.3% of all deaths (National Vital Stats). Sudden cardiac death represents 63% of all cardiac deaths. (Mortality and Morbidity Weekly Review (MMWR), Feb 15, 2002) Therefore SCA accounts for 19.1% of deaths, more than all other causes except all cancers combined. The majority of underlying arrhythmias of sudden cardiac arrest are ventricular tachyarrhythmias. The data from this study were collected were based on Holter recordings at the time of cardiac arrest. Focusing on cardiac arrest survivors is NOT the answer because these patients represent only a very small percentage of the total number of patients who experience SCA each year. To address the greatest number of patients, primary prevention therapies will be required. Today, we can effectively identify/treat a very small portion of the total number of patients who experience SCA. SCD-HeFT may siginficantly increase our ability to treat high-risk heart failure patients. Victim:受害人, 牺牲者, 牺牲品 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. Mortality:死亡率 The authors speculated that this altered temporal distribution of SCD may be because beta-blockers seem to provide an increased protection from an early occurrence of SCD. The AVID trial documented the rat