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排序方式: 共有1469条查询结果,搜索用时 663 毫秒
1.
慢性心力衰竭(心衰)患者中有30%——50%会发生猝死,为了改善预后不仅关注心衰本身引起的死亡,还要重视对猝死的对策。8受体阻断剂、血管紧张素转换酶抑剂和胺碘酮能降低猝死的危险,但效果不能令人满意。心衰患者的猝死很难预测时,植入心律转复除颤器(ICD)会发挥难以替代的作用。欧洲和美国的大型试验已证明,ICD对猝有一级和二级预防作用,ICD的适用范围正在变宽。此外,心衰患者中伴室内传导阻滞者,室收缩的同步性发生障碍,而ICD恰好能使两心室电活动同步,所以在欧美ICD的应用已较普及。考虑到医疗费用的同时,今后ICD在日本应用的适应证,即对心衰患者发生猝死险的评价变得尤为重要。 相似文献
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Donna White Suzanne Moore Stephen Waring Karon Cook Eugene Lai 《Movement disorders》2007,22(7):915-923
To better understand the impact of incident Parkinson's disease (PD) on the Veteran's Health Administration (VHA) and to develop methods applicable to future epidemiological research, we performed a medical record review study at a tertiary referral VHA medical center. Searching the local data base, we identified 782 veterans with diagnostic codes for PD or secondary parkinsonism (SP) between 1998 and 2000. Based on structured medical record review, a movement disorders specialist confirmed diagnoses for incident parkinsonism cases. Among the 782, 191 incident parkinsonism cases were identified (100 PD, 75 SP, and 16 Parkinson's Plus). Incident PD cases were older at diagnosis (74.5 vs. 70.4 yr; P < 0.05) and more likely to be white (81% vs. 62; P < 0.07) than incident SP cases. Diagnostic codes were insufficient to distinguish between incident PD and SP (positive predictive value, 57% and 39%, respectively), and VHA sources failed to identify 21% of confirmed deaths among the incident PD cohort by November 2004. Although the large number of incident cases identified suggests PD is an important cause of disability among elderly VHA users, observed limitations of VHA sources for identifying incident PD cases and determining their vital status should be considered when designing future studies. 相似文献
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F. Wellens P. Brugada G. Guiraudon Y. De Grieck R. De Geest H. Vanermen 《European journal of cardio-thoracic surgery》1994,8(12):628-634
Internal cardioverter defibrillator (ICD) implantation has become a standard therapy for life-threatening arrhythmias. A simple and safe surgical implantation technique is therefore mandatory in this high risk population. In a 30-month period 86 patients received 87 ICD devices. An endocavitary lead system was used as first choice in 62 patients and defibrillation thresholds (DFT) of 25 joules (J) or less were obtained in 57 patients. A thoracotomy approach was avoided using a biphasic shock wave form in 17 patients and the addition of a subcutaneous (sc) patch in 11 patients or wire array lead in 9 patients. There was one early non-technique related death (1.7%) after the transvenous approach. Reoperation was necessary in three patients with lead complications and in two patients for local device problems (one migration, one infection). With the recent progress in ICD technology, a thoracotomy approach could be avoided for the last 52 patients. For comfort and cosmetic reasons left subcostal insertion of the device has been successfully used in the last 50 patients. We conclude that the nonthoracotomy approach can now be offered to all patients in need for an ICD as a consequence of the technological progress made in the field of electric treatment of malignant ventricular arrhythmias. A stepwise approach with a minimum of implanted hardware and the use of biphasic shock systems now offers a simple and efficient treatment alternative with very low perioperative risk. Internal cardioverter defibrillator implantation in combination with open heart procedures can easily be avoided. 相似文献
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LUKAS R.C. DEKKER TIM A.M. SCHRAMA FRANS H.L. STEINMETZ RAYMOND TUKKIE 《Pacing and clinical electrophysiology : PACE》2004,27(6P1):833-834
We describe a case of potentially fatal undersensing of VF by a third generation ICD with predetermined automatic gain control. In this patient, ventricular sensing was optimal, as R wave amplitudes during sinus rhythm were at least 16 mV. Cyclical, high amplitude signals during VF elevated the sensing floor to such an extent that complete undersensing of subsequent lower amplitude local electrograms occurred. This led to bradypacing and complete ICD therapy failure. Therefore, high R wave amplitudes during sinus rhythm do not warrant flawless sensing during VF. (PACE 2004; 27[Pt. I] 833–834) 相似文献
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STEEN M. JENSEN ADRIAN PIETERSEN XU CHEN 《Pacing and clinical electrophysiology : PACE》1998,21(2):476-477
Routinely the active can ICD is placed in the left side pectoral position, which theoretically gives optimal conditions for a low defibrillation threshold. Some patients, bowever, demand a right pectoral position, which possibly could result in a bigger defibrillation threshold. A right pectoral position was used in 3 of 85 active can ICDs implanted in our institution from 1994. the DFT was 12 J in two and 18 f in one patient. Thus, right pectoral implantation is feasible and offers an alternative approach in selected patients. 相似文献
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Primary Prevention of Sudden Cardiac Death in Heart Failure: Will the Solution Be Shocking? 总被引:10,自引:0,他引:10
Barry F Uretsky MD Richard G Sheahan MD 《Journal of the American College of Cardiology》1997,30(7):1589-1597
Sudden cardiac death (SCD) may occur in as many as 40% of all patients who suffer from heart failure. This review describes the scope of the problem, risk factors for SCD, the effect of medications used in heart failure on SCD and the potential effect of the implantable cardioverter-defibrillator in primary prevention. 相似文献
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38所综合医院病种质量管理调查分析 总被引:7,自引:1,他引:7
搜集整理吉林省 38所二、三级综合医院为期一年的 31个病种3.4万份病例的信息资料,对其治疗转归、平均住院日和平均住院费用进行了统计分析,为制定病种质量控制标准和深入广泛开展病种质量管理提供了可靠依据。 相似文献