表抗心律失常治疗对猝死二级预防的研究汇总 Trials Therapy Study Size All-cause mortality Population (F-U duration) CASCADE Empirical amiodarone vsIF202 Including resuscitated VF and Cardiac arrest guided conventional (6 years) syncopal defibrillator shocks 47% survivors antiarrhythmic therapy vS 60%(guided therapy)P=0.007 Wever Implantable defibrillator n60 Including sudden circulatory Cardiac arrest as first choice (24 months) arrest and terminal pump failure survIvors 14% vs 35%(control) p=0.02 AVID Implantable defibrillator F1016 158%V24.0% Patients resuscitated vs class Ill drugs (18.2 months) from cardiac arrest or (mainly amiodarone) P<0.02 poorly tolerated VT CASH Groups: implantable m346 Propafenone limb nterrupted due Cardiac arrest defibrillator, amiodarone,(2 years) to excess mortality 12. 1% vS survIvorS metoprolol, Propafenone .6%(drug limb CIDS Implantable defibrillator=659 25%w30% Cardiac arrest vs amiodarone (3 years) (amiodarone) survivors and patients p=0.072 with poorly tolerated 月前支持用CDs进行二级预防,CDs已成为心脏猝死病 人复苏后首选的预防措施Trials Therapy Study Size All-cause mortality Population (F-U duration) CASCADE Wever et al AVID CASH CIDS Empirical amiodarone vs guided conventional antiarrhythmic therapy Implantable defibrillator as first choice Implantable defibrillator vs class III drugs (mainly amiodarone) Groups:implantable defibrillator, amiodarone, metoprolol, Propafenone Implantable defibrillator vs amiodarone n=202 (6 years) n=60 (24 months) n=1016 (18.2 months) n=346 (2 years) n=659 (3 years) Including resuscitated VF and syncopal defibrillator shocks 47% vs 60% (guided therapy) P=0.007 Including sudden circulatory arrest and terminal pump failure 14% vs 35% (control) p=0.02 15.8% vs 24.0% (drugs) P<0.02 Propafenone limb interrupted due to excess mortality 12.1% vs 19.6% (drug limb) p=0.047 25% vs 30% (amiodarone) p=0.072 Cardiac arrest survivors Cardiac arrest survivors Patients resuscitated from cardiac arrest or poorly tolerated VT Cardiac arrest survivors Cardiac arrest survivors and patients with poorly tolerated VT 表 I 抗心律失常治疗对猝死二级预防的研究汇总 结 论: 目 前 支 持 用ICDs 进 行 二 级 预 防，ICDs 已 成 为 心 脏 猝 死 病 人 复 苏 后 首 选 的 预 防 措 施