A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias.
A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias.
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对从近乎致命的室性心律失常中复苏的患者进行抗心律失常药物治疗与植入式除颤器的比较。
DOI：
10.1056/nejm199711273372202
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
中科院分区：
文献类型：
--
作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
背景：在危及生命的室性心律失常中存活下来的患者有心律失常复发的风险。他们可以用植入式心律转复除颤器或抗心律失常药物治疗，但这两种治疗策略的相对疗效是unknow.MethodsTo解决这个问题，我们进行了一个随机比较这两种治疗策略的患者谁已经复苏从近致命的室颤或谁经历了心脏复律持续室性心动过速。室性心动过速患者也有晕厥或其他严重的心脏症状，沿着左心室射血分数≤ 0.40，一组患者植入心律转复除颤器，另一组接受III类抗心律失常药物，主要是经验确定剂量的胺碘酮。五十六个临床中心在近四年的时间里筛选了所有出现室性心动过速或室颤的患者。在1016名患者中（45%的患者有室颤，55%的患者有室性心动过速），507名患者被随机分配接受植入式心律转复器治疗，509名患者接受抗心律失常药物治疗。主要终点是总死亡率。结果随访完成1013例（99.7%）。植入式除颤器组的总生存率更高，未经调整的估计值为89.3%，而抗心律失常药物组的总生存率为82.3%，两年为81.6%，三年为75.4%，三年为64.1%（P<0.02）。相应的死亡率降低（95%置信限）与植入式除颤器分别为39± 20%，27 ± 21%，31 ± 21%.ConclusionsAmong室颤或持续性室性心动过速造成严重症状的幸存者，植入式心律转复除颤器是上级抗心律失常药物提高总生存率。
BackgroundPatients who survive life-threatening ventricular arrhythmias are at risk for recurrent arrhythmias. They can be treated with either an implantable cardioverter–defibrillator or antiarrhythmic drugs, but the relative efficacy of these two treatment strategies is unknown.MethodsTo address this issue, we conducted a randomized comparison of these two treatment strategies in patients who had been resuscitated from near-fatal ventricular fibrillation or who had undergone cardioversion from sustained ventricular tachycardia. Patients with ventricular tachycardia also had either syncope or other serious cardiac symptoms, along with a left ventricular ejection fraction of 0.40 or less. One group of patients was treated with implantation of a cardioverter–defibrillator; the other received class III antiarrhythmic drugs, primarily amiodarone at empirically determined doses. Fifty-six clinical centers screened all patients who presented with ventricular tachycardia or ventricular fibrillation during a period of nearly four years. Of 1016 patients (45 percent of whom had ventricular fibrillation, and 55 percent ventricular tachycardia), 507 were randomly assigned to treatment with implantable cardioverter–defibrillators and 509 to antiarrhythmic-drug therapy. The primary end point was overall mortality.ResultsFollow-up was complete for 1013 patients (99.7 percent). Overall survival was greater with the implantable defibrillator, with unadjusted estimates of 89.3 percent, as compared with 82.3 percent in the antiarrhythmic-drug group at one year, 81.6 percent versus 74.7 percent at two years, and 75.4 percent versus 64.1 percent at three years (P<0.02). The corresponding reductions in mortality (with 95 percent confidence limits) with the implantable defibrillator were 39±20 percent, 27±21 percent, and 31±21 percent.ConclusionsAmong survivors of ventricular fibrillation or sustained ventricular tachycardia causing severe symptoms, the implantable cardioverter–defibrillator is superior to antiarrhythmic drugs for increasing overall survival.
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影响因子：
37.8
作者：
POWELL, AC;FUCHS, T;RUSKIN, JN
通讯作者：
RUSKIN, JN
植入心脏复律除颤器后的存活率。
影响因子：
2.8
作者：
D. Newman;M. Sauvé;J. Herre;J. Langberg;Michael A. Lee;C. Titus;J. Franklin;M. Scheinman;J. Griffin
通讯作者：
J. Griffin
冠心病院外心脏骤停复苏患者的预测生存模型。
影响因子：
37.8
作者：
Sidney Goldstein;J. Landis;R. Leighton;G. Ritter;C. Vasu;R. Wolfe;A. Acheson;S. Medendorp
通讯作者：
S. Medendorp
DOI：
10.1097/00132586-199404000-00006
发表时间：
1994-04
期刊：
Survey of Anesthesiology
影响因子：
--
作者：
J. Mason
通讯作者：
J. Mason
影响因子：
158.5
作者：
Moss, AJ;Hall, WJ;Heo, M
通讯作者：
Heo, M