A critical appraisal of implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death
A critical appraisal of implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death
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DOI：
10.1016/j.jacc.2008.05.058
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发表时间：
2008-09-30
影响因子：
24
通讯作者：
Josephson, Mark E.
中科院分区：
文献类型：
--
作者：
Tung, Roderick;Zimetbaum, Peter;Josephson, Mark E.
在过去的10年里，植入式心律转复器（ICD）用于预防心脏性猝死的适应症迅速扩大。临床试验数据已迅速纳入指南，而没有对证据的优势和局限性进行严格的重新评估。ICD治疗具有固有风险，包括感染、不必要的电击、致心律失常的可能性、器械故障、高度宣传的制造商声明和手术并发症，这些风险可能对发病率和生活质量产生不利影响。重新评估ICD治疗的益处和潜在危害将使医生能够与患者进行更加相互了解和平衡的对话。
The indications for implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death have rapidly expanded over the past 10 years. Clinical trial data have quickly been implemented into guidelines without critical reassessment of the strengths and limitations of the evidence. ICD therapy has inherent risks including infection, unnecessary shocks, potential for proarrhythmia, device malfunction, highly publicized manufacturer advisories, and procedural complications, which can adversely affect morbidity and quality of life. A reappraisal of the benefits and potential hazards of ICD therapy will enable physicians to a have a more mutually informed and balanced dialogue with their patients.