循環器ジャーナル68巻3号

2020年07月発行

特集 不整脈治療の最新デバイステクノロジーとリードマネジメント Ⅱ．除細動治療

植込み型除細動器（ICD）

著者： 中井俊子¹

所属機関： ¹日本大学医学部内科学系先端不整脈治療学分野

ページ範囲：P.438 - P.444

Point
・植込み型除細動器は，心臓突然死を防止できる唯一かつ最も有効な手段である．
・日本においては，一次予防としてのICD植込みは少なく，突然死予防の観点から重要な課題となっている．
・ショック作動は患者のQOL低下を招くだけでなく，生命予後にも関与する．抗頻拍ペーシングを積極的に設定し，ショック作動を少なく，特に不適切作動は限りなくゼロにする管理を心掛けたい．

参考文献

1) van Alem AP, Vrenken RH, de Vos R, et al:Use of automated external defibrillator by first responders in out of hospital cardiac arrest:prospective controlled trial. BMJ 327:1312-1326, 2003

2) 日本循環器学会：不整脈非薬物治療ガイドライン（2018改訂版），2019　http://www.j-circ.or.jp/guideline/pdf/JCS2018_kurita_nogami.pdf

3) Kitamura S, Satomi K, Kurita T, et al:Long-term follow-up of transvenous defibrillation leads:high incidence of fracture in coaxial polyurethane lead. Circ J 70:273-277, 2006

4) Watanabe E, Okajima K, Shimane A, et al:Inappropriate implantable cardioverter defibrillator shocks-incidence, effect, and implications for driver licensing. J Interv Card Electrophysiol 49:271-280, 2017

5) Asakai H, Shimizu A, Mitsuhashi T, et al:Current Trends in Implantable Cardioverter-Defibrillator Therapy in Children-Results From the JCDTR Database. Circ J 83:52-55, 2018

6) Souza FSO, Matos VS, Almeida MCV, et al:Subcutaneous Implantable Cardioverter Defibrillator:Early Experience. Braz J Cardiovasc Surg 32:498-502, 2017

7) Boersma L, Barr C, Knops R, et al:Implant and Midterm Outcomes of the Subcutaneous Implantable Cardioverter-Defibrillator Registry:The EFFORTLESS Study. J Am Coll Cardiol 70:830-841, 2017

8) Wathen MS, DeGroot PJ, Sweeney MO, et al:Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators:Pacing Fast Ventricular Tachycardia Reduces Shock Therapies（PainFREE Rx Ⅱ）trial results. Circulation 110:2591-2596, 2004

9) Daubert JP, Zareba W, Cannom DS, et al:Inappropriate implantable cardioverter-defibrillator shocks in MADIT Ⅱ:frequency, mechanisms, predictors, and survival impact. J Am Coll Cardiol 51:1357-1365, 2008

10) Watanabe T, Inoue K, Kashiwase K, et al:Efficacy of anti-tachycardia pacing for terminating fast ventricular tachycardia in Japanese implantable cardioverter defibrillator patients. Primary results of the SATISFACTION study. Circ J 78:2643-2650, 2014

11) Gulizia MM, Piraino L, Scherillo M, et al:A randomized study to compare ramp versus burst antitachycardia pacing therapies to treat fast ventricular tachyarrhythmias in patients with implantable cardioverter defibrillators:the PITAGORA ICD trial. Circ Arrhythm Electrophysiol 2:146-153, 2009

12) Moss AJ, Schuger C, Beck CA, et al:Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med 367:2275-2283, 2012

13) Auricchio A, Schloss EJ, Kurita T, et al:Low inappropriate shock rates in patients with single-and dual/triple-chamber implantable cardioverter-defibrillators using a novel suite of detection algorithms:PainFree SST trial primary results. Heart Rhythm 12:926-936, 2015

14) Hindricks G, Taborsky M, Glikson M, et al:Implant-based multiparameter telemonitoring of patients with heart failure（IN-TIME）:a randomised controlled trial. Lancet 384:583-590, 2014

15) 日本不整脈心電学会：心臓植込型デバイスにおける遠隔モニタリングステートメント．2016　http://new.jhrs.or.jp/guideline/statement201607_01/