Shocking therapy of implanted cardioverter defibrillator (ICD) has been criticized for its causing myocardium damage and inducing electrical storm. Instead the anti-tachycardia pacing (ATP) function has been introduced as the main pain-free therapy of ICD, which could terminate about 3/4 ventricular tachycardia ( VT) events, without raising the risk of syncope or accelerated VT. The main concerns of ATP include differential identification of supraventricular tachycardia, re-confirmation of charging, settings of fast VT zone, strategies for optimization, and ATP while or before charging etc. , and the parameters should be adjusted individually during follow up. More concern should be paid to pain-free ICD therapy in clinical practice.%电击治疗可导致包括心肌损伤及诱发植入式心脏复律除颤器电风暴等弊端.植入式心脏复律除颤器的无痛性治疗主要是指其抗心动过速起搏功能.抗心动过速起搏能成功终止约3/4的室性心动过速事件,不增加晕厥或加速室性心动过速.无痛性治疗的主要策略包括室上性心动过速的鉴别程序、充电时的再确认、设定快速室性心动过速区、抗心动过速起搏策略优化、充电中和充电前抗心动过速起搏等.这些参数设置应个体化并在随访中进行调整.应重视植入式心脏复律除颤器无痛性治疗在临床上的应用.
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