埋藏式心律自动转复除颤器的无痛治疗

Painless Therapy of Implantable Cardioverter-Defibrillator

埋藏式心律自动转复除颤器是近年来发明的一种针对恶性快速性室性心律失常的治疗方法。埋藏式心律自动转复除颤器的无痛治疗主要指抗心动过速起搏治疗,即通过发放比室性心动过速频率更快的短阵快速起搏来终止室性心动过速,同时并不增加患者痛苦。其中,针对折返性室性心动过速最为有效。其最基本的快速起搏方式包括:猝发起搏、扫描起搏、递增起搏及复合起搏。无痛治疗的设置包括频率分区、抗心动过速起搏治疗参数及其他辅助功能等。抗心动过速起搏治疗是终止快速性室性心动过速的首选治疗方式。

Implantable cardioverter-defibrillators （ICDs） are the most effective therapy for patients with malignant ventricular arrhyth- mias at high risk for sudden cardiac death in recent years. Painless therapy of implantable eardioverter-defibrillator mainly refers to anti-tach- yeardia pacing therapy （ATP）, which the ICD delivers a burst of ventricular-paced beats at a rate faster than the underlying arrhythmia, with less patient discomfort, and possibly lower risks of adverse health outcomes. This approach is most effective for terminating reentrant tachycardia. The basic pacing modes of ATP include ： Burst, Scan, Ramp, and Ramp ＋ Scan. The programming of ATP consists of cutoff rate, parameters of ventricular pacing and other auxiliary functions. ATP may be the first choice for the termination of ventricular tachycardia episodes.