Risk stratification in surgically repaired tetralogy of Fallot.
Risk stratification in surgically repaired tetralogy of Fallot.
复制标题
DOI：
10.1586/erc.09.38
复制
发表时间：
2009-07-01
影响因子：
2
通讯作者：
Mercier, Lise-Andree
中科院分区：
文献类型：
--
作者：
Khairy, Paul;Dore, Annie;Mercier, Lise-Andree
法洛四联症是植入式心脏复律除颤器 (ICD) 接受者最常见的先天性心脏病。事实上，疑似心律失常病因导致的猝死是法洛四联症手术修复患者最常见的死亡模式，通常发生在成年早期至中期。然而，每年猝死的总体发生率实际上很低。这就是风险分层的主要挑战。这篇综述强调了对法洛四联症患者进行风险分层的一些复杂性，强调了通过规定治疗的严格算法避免过度简单化的重要性。为了补充合理的临床判断，提出了一种定量概率方法，该方法考虑了一级预防 ICD 试验的文献、观察性研究确定的危险因素、程序性心室刺激的价值以及从研究法洛四联症 ICD 接受者中收集的见解。
Tetralogy of Fallot is the most common form of congenital heart disease in implantable cardioverter-defibrillator (ICD) recipients. Indeed, sudden death of presumed arrhythmic etiology is the most frequent mode of demise in patients with surgically repaired tetralogy of Fallot, often in early-to-mid adulthood. Nevertheless, the overall annual incidence of sudden death is actually low. Therein lies the major challenge of risk stratification. This review highlights some of the complexities involved in risk stratifying patients with tetralogy of Fallot, underscoring the importance of avoiding oversimplification by means of a rigid algorithm that dictates therapy. To complement sound clinical judgment, a quantitative probabilistic approach is presented, which considers the body of literature from primary prevention ICD trials, risk factors identified by observational studies, the value of programmed ventricular stimulation and insights gleaned from studying ICD recipients with tetralogy of Fallot.