Health Technology Assessment Reports, 1985. Number 16. Implantable Automatic Cardioverter-Defibrillators

摘要

The automatic implantable cardioverter-defibrillator (AICD) is an electronic device designed to treat life-threatening ventricular tacharrhythmias. It consists of a pulse generator and electrodes for sensing and defibrillating. The device monitors a patient's heart beat and initiates a charge sequence when an arrhythmia is detected. If the initial discharge is unsuccessful in terminating the arrhythmia, up to three additional shocks may be delivered. Patients who have survived an episode of cardiac arrest are at high risk of recurrence. For patients who fail medical or surgical therapy guided by electrophysiologic studies, AICD is a treatment of last resort. Published experience with the device is limited. The two major published series have reported reductions in mortality rates as a result of implantation of the AICD. Patients had one year arrhythmic mortality rates of 2 percent and 1.8 percent in the two studies, respectively. One year mortality rates in the studies were 10.1 percent (cardiovascular) and 16.6 percent (total) respectively.