恶性室性心律失常的危险分层与治疗评价--培训课件.ppt

恶室性性心律失常的其他治疗方法 切除异位兴奋灶或切除病灶(室壁瘤) 迷宫手术 心脏血管搭桥术(间接) 瓣膜置换术(间接) 骨髓干细胞移植治疗 * Average of 156 SCD events per year per 100,000 population in industrialized countries Less than 1% survive to reach the hospital in many parts of the world. * Average of 156 SCD events per year per 100,000 population in industrialized countries Less than 1% survive to reach the hospital in many parts of the world. * Approximately 300,000 Americans die from Sudden Cardiac Arrest every year. Data from 1996 shows that other major causes of death affected fewer people: SCA ~300,000 Stroke 160,500 Lung Cancer 153,000 Breast Cancer 44,100 AIDS 37,000 Fire 5,000 * Average of 156 SCD events per year per 100,000 population in industrialized countries Less than 1% survive to reach the hospital in many parts of the world. * The majority (83%) of arrhythmias leading to SCA are tachyarrhythmias. * EF = left ventricular ejection fraction VT/VF = ventricular tachycardia – ventricular fibrillation Estimates of the incidence and total number of SCDs per year are shown for the overall adult population and for higher risk subgroups. The overall estimated incidence is 0.1 – 0.2% per year, totaling more than 300,000 deaths per year in the U.S. * The chance of a successful resuscitation declines by about 7–10% each minute. The actual relationship between defibrillation success and time is a non-linear one, with the best chance for success probably occurring in the first 3–4 minutes. * Studies have identified several factors that increase a patient’s risk for SCA. Individual risk factors are more predictive of SCA if they are combined with other risk factors. NOTE: Slides are provided on each risk factor if additional information is desired. * Although the highest risk factor for SCA is a previous cardiac arrest, survival rates are extremely low. It is critical to identify other risk factors so that high-risk patien