Subcutaneous or Transvenous Defibrillator Therapy

Subcutaneous or Transvenous Defibrillator Therapy
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皮下或经静脉除颤器治疗

DOI:
10.1056/nejmc2034917
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发表时间:
2021
期刊:
The New England Journal of Medicine
影响因子:
--
通讯作者:
Ayumi Nojiri
Ayumi Nojiri
中科院分区:
--
文献类型:
--
作者:
Tomohiko Sato;Ayumi Nojiri

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编者按:与之前的植入式除颤器试验相比,Praetorian试验涉及的心脏功能和室内传导保存更好的患者队列较少。1-3在本试验中,皮下ICD并不明显低于标准的经静脉ICD。猝死可由室性心动过速或室颤或心搏停止引起;经静脉ICD可通过复律、除颤、抗心动过速起搏或标准起搏来解决这些问题。皮下ICD只有这四种能力中的两种,只处理室性心动过速或室颤,而不是心搏停止。心脏骤停通常是心搏停止,4特别是当心脏功能严重受损或传导障碍时。
To the Editor: The PRAETORIAN trial involved a smaller cohort of patients with better-preserved ventricular function and intraventricular conduction than those in previous trials of implantable defibrillators. 1-3 In this trial, the subcutaneous ICD was not significantly inferior to a standard transvenous ICD.Sudden death can result from ventricular tachycardia or ventricular fibrillation or from asystole; the transvenous ICD can address any of these by cardioversion, defibrillation, antitachycardia pacing, or standard pacing. The subcutaneous ICD has only two of these four capabilities and addresses only ventricular tachycardia or ventricular fibrillation, not asystole. Cardiac arrest is often asystolic, 4 particularly when ventricular function is severely impaired or if conduction is disturbed.
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