植入型心律转复除颤器的植入技术和随访

植入型心律转复除颤器的植入技术 我国于1992年开始在临床使用植入型心律转复除颤器(ICD),因为是开胸手术,创伤大,比较复杂,5年中仅约10例患者使用此技术。近年来由于经静脉单导线植入技术的开展,创伤小,手术简化,采用ICD治疗的病人逐渐增     

ICD的临床应用

一系列多中心临床试验证明植入型心律转复除颤器(ICD)是优于药物有效治疗心脏猝死(SCD)方法。为提高临床医师对应用ICD的认识及使用规范化，现就ICD植入技术、随诊内容、注意事项总结如下。     

植入型心律转复除颤器临床应用中国专家共识（2021）

心脏性猝死（SCD）愈发成为临床和公共卫生问题。植入型心律转复除颤器（ICD）是目前预防SCD最为有效的治疗措施。目前临床应用的ICD分为经静脉植入型心律转复除颤器（TV-ICD）和全皮下植入型心律转复除颤器（S-ICD）,无论器械本身还是相关临床研究近年都得到了长足进展。ICD对SCD的预防包括二级和一级预防,符合S...     

植入心律转复除颤器患者的猝死:心律失常事件和器械应答之间的临床关系

植入型心律转复除颤器(ICD)治疗室性快速性心律失常的疗效已得到充分证明。但是,ICD对猝死性心律失常的保护作用并非绝对可靠。目前,人们对ICD植入者猝死的特征及潜在原因知之甚少。该研究目的有两个:首先,确定第三代ICD植入者与猝死相关联的心律失常事件;其次,确定与ICD植入者猝死有关的临床或非临床因素。     

植入型心律转复除颤器治疗与相关技术的最新进展

植入型心室复律除颤器即通常所指的植入型心律转复除颤器 (ICD) ,是目前公认防治致命性室性心律失常 (室速/室颤 )的一线治疗措施。广义上讲 ,植入型心律转复除颤器还包括植入型心房复律除颤器 (IAD)和房室双腔复律除颤器。近年来IAD的实验研究不断增多 ,并已在临床小规模应用 ,可望成为治疗房颤的另一有效手段。房室双腔复律除颤器集IAD和ICD功能于一身 ,能够放电终止房颤、室速和室颤。1　植入型心房复律除颤器目前临床应用的IAD ,体积与普通起搏器相仿 ,重量在10 0g以内 ,除颤脉冲波形为双相 ,放电能量 2～ 10J。其右心房电极主…     

植入型心律转复除颤器对特发性心室颤动的治疗三例

随着植入型心律转复除颤器（implantable cardioverter defibrillator,ICD）的技术改进及程控参数的多元化,其操作更加简单,应用也更加普及.多中心临床试验确立了对非一过性或可逆性原因引起的室性心动过速（室速）和心室颤动（室颤）所致的心脏骤停幸存者，ICD为一线治疗。本文报告3例ICD植入病例，探讨ICD对特发性室颤的治疗效果以及诊断和随访过程中所遇到的问题。     

教育与心理支持对ICD使用者至关重要

每月约有10,000名美国人接受心脏除颤器(ICD)植入治疗,以帮助建立健康的心脏节律并预防心源性猝死。但美国心脏协会提出,装置心脏除颤器患者,同时应植入与之相适应的心理支持。最近发表于《循环》杂志的一份AHA声明纳入如下建议,例如确保接受ICD植入的患者     

ICD的无痛治疗在心脏性猝死预防中的应用

植入型心律转复除颤器（ICD）是预防心脏性猝死的最重要的手段。ICD的无痛性治疗又称抗心动过速起搏（ATP）治疗,是ICD终止室速的最重要治疗方法。如何在保证患者安全的前提下减少ICD放电．特别是减少不恰当放电,更好地应用ICD技术为患者服务,深入了解和掌握无痛性ATP治疗十分重要。本文就ICD无痛ATP治疗相关内容及进展进行综述。     

埋藏式心律转复除颤器的除颤电极植入部位对三尖瓣反流的影响

目的:探讨埋藏式心律转复除颤器(ICD)的除颤电极在右心室不同植入位置与三尖瓣反流进展的相关性.方法:回顾性纳入2016年1月至2019年12月于中国医学科学院阜外医院心律失常中心植入ICD或心脏再同步治疗除颤器(CRT-D)患者198例.所有患者在术前及术后均完善超声心动图,根据三尖瓣反流面积分为无、轻、中、重度四级...     

紧急远程程控植入型心律转复除颤器不恰当电击1例

植入型心律转复除颤器(ICD)患者遭受电击时, 程控医师应对其设备进行及时有效的询问及参数修改。本文报道1例远程程控在ICD不恰当电击患者中的成功应用。     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

高血压降压治疗目标的再认识

根据传统的高血压水平的定义,1993年WHO高血压治疗指南提出血压控制目标为<140/90mm Hg(1mm Hg=0.133kPa),但是并非所有患者都必须将血压降至同一水平,而应根据患者情况进行个体化治疗。Framingham进行的一项长达10～12年的心血管事件研究发现,第5年后,正常上限血压[收缩压(SBP     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.