Implantable cardioverter defibrillator(ICD) programminginvolves several parameters. In recent years antitachycardia pacing(ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether ...Implantable cardioverter defibrillator(ICD) programminginvolves several parameters. In recent years antitachycardia pacing(ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient's quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias(188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation(VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.展开更多
The term "electrical storm"(ES)in patients with an implantable cardioverter defibrillator(ICD)indicates a state of cardiac electrical instability manifested by several episodes of ventricular tachyarrhythmia...The term "electrical storm"(ES)in patients with an implantable cardioverter defibrillator(ICD)indicates a state of cardiac electrical instability manifested by several episodes of ventricular tachyarrhythmias(VTs)and ventricular fibrillation within a short time.In this article,we have reviewed the definition,incidence,triggers,treatment,prevention and prognosis of ES in patients with ICD.The role of ICD programming such as antitachycardia pacing(ATP)is highly effective,equally safety,and improves the quality of life.ATP may be the preferred fasicular ventricular tachycardia therapy in most ICD patients.The reduction of the elevated sympathetic tone by beta blockers is one of the key intervention in ES.The combination of amiodarone therapy is determined by the individual condition of patients.ES seems to have an impaired prognosis and frequently leads to hospitalization.Long-term prognostic implications of ES are unclear.展开更多
文摘Implantable cardioverter defibrillator(ICD) programminginvolves several parameters. In recent years antitachycardia pacing(ATP) has gained an increasing importance in the treatment of ventricular arrhythmias, whether slow or fast. It reduces the number of unnecessary and inappropriate shocks and improves both patient's quality of life and device longevity. There is no clear indication regarding the type of ATP to be used, except for the treatment of fast ventricular tachycardias(188 bpm-250 bpm) where it has been shown a greater efficacy and safety of burst compared to ramp; 8 impulses in each sequence of ATP appears to be the best programming option in this setting. Beyond ATP use, excellent clinical results were obtained with programming standardization following these principles: extended detection time in ventricular fibrillation(VF) zone; supraventricular discrimination criteria up to 200 bpm; first shock in VF zone at the maximum energy in order to reduce the risk of multiple shocks. The MADIT-RIT trial and some observational registries have also recently demonstrated that programming with a widespread use of ATP, higher cut-off rates or delayed intervention reduces the number of inappropriate and unnecessary therapies and improves the survival of patients during mid-term follow-up.
文摘The term "electrical storm"(ES)in patients with an implantable cardioverter defibrillator(ICD)indicates a state of cardiac electrical instability manifested by several episodes of ventricular tachyarrhythmias(VTs)and ventricular fibrillation within a short time.In this article,we have reviewed the definition,incidence,triggers,treatment,prevention and prognosis of ES in patients with ICD.The role of ICD programming such as antitachycardia pacing(ATP)is highly effective,equally safety,and improves the quality of life.ATP may be the preferred fasicular ventricular tachycardia therapy in most ICD patients.The reduction of the elevated sympathetic tone by beta blockers is one of the key intervention in ES.The combination of amiodarone therapy is determined by the individual condition of patients.ES seems to have an impaired prognosis and frequently leads to hospitalization.Long-term prognostic implications of ES are unclear.
