室性心律失常的治疗及进展

自从认识到心脏骤停作为心脏性猝死的机制具有很高的发生率以来,医学和临床医生一直在追求一种方法来预测及预防这些心血管事件。在室性心律失常患者中已经完成的一些安慰剂对照的抗心律失常药物试验并没有一致地认为抗心律失常药物治疗能够降低总病死率。近几年发表的临床随机试验证明,植入型心脏复律除颤器与传统的抗心律失常治疗相比,可降低高危亚组患者的病死率。然而,在患者中识别致死性室性心律失常的危险性及衡量使用植入型心脏复律除颤器治疗的价-效比已经成为当今的社会医学问题,尤其在美国。室性心律失常的治疗和心脏性猝死预防仍是将来需要关注的问题。

Therapy of Ventricular Arrhythmia

Since the recognition of the high incidence of cardiac arrest as the mechanism of sudden cardiac death (SCD),medical scientists and clinicians have sought methods to predict and prevent these events.Many placebo-controlled antiarrhythmic drug trials have been completed in ventricular arrhythmic patient groups,but these trials have not uniformly reported a benefit from antiarrhythmic drugs in reduction of all-cause mortality.Recently published randomized studies demonstrating that the implantable cardioverter defibrillator (ICD) provides a mortality benefit compared with conventional drug therapy in highly specific subsets of patients.However,identifying risk of fatal ventricular arrhythmias among the patients and cost-effectiveness of ICD has become a social medical problem,especially in USA.It is still needed to pay attention to the therapy of ventricular arrhythmia and prevention of SCD in the future.