Author/Editor		Vokač, Damijan
Title		Implantabilni kardioverterji defibrilatorji in posebne oblike elektrostimulacije
Translated title		Implantable cardioverter defibrillator and special kind of electrostimulation therapy
Type		članek
Source		In: Hojs R, Krajnc I, Pahor A, et al, editors. Zbornik predavanj in praktikum 15. srečanje internistov in zdravnikov splošne medicine Iz prakse za prakso z mednarodno udeležbo; 2004 maj 7-8; Maribor. Maribor: Splošna bolnišnica Maribor,
Publication year		2004
Volume		str. 113-23
Language		slo
Abstract		Sudden cardiac death presents approximately 50% of all deaths from cardiovascular causes. Despite successful cardiovascular therapy, patients with left ventricular dysfunction remain at high risk of sudden cardiac death. The implantable cardiovascular defibrillator introduced to clinical medicine in the last iwo decades effectively terminates most episodes of ventricular fibrillation and tachycardia. It differs from medical treatment because of straightfonvard action regardless of the mechanism of arrhythmia. Several randomized clinical trials have been performed in the last years, roughly divided in those of secondary prevention, with patients randomized after aborted sudden cardiac death, and those of primary prevention, targeted asymptomatic patients with high risk of sudden death. Both trials as from primary and secondary prevention fairly support therapy with implantable cardioverter defibrillators against medical treatment. A special group of cardiac patients represents those with advanced left ventricular dysfunction with a mortality rate up to 70% due to ventricular tachyarrhythmias. In this group with severe left ventricular dysfunction and left bundle branch block, resynchronization therapy using biventricular pacing is highly successful regarding acute and chronic hemodynamic effects. Despite successful hemodynamic effects, the mortality rate due to sudden cardiac death remains high. Due to effective resynchronization therapy and prevention of sudden death in this group of patients, the combination therapy with biventricular implantable cardioverter defibrillator is becoming an important non-medical therapy for advanced heart failure. Combined biventricular pacing and implantable defibrillator is complex and expensive, but in the targeted group of patients an economically acceptable therapy. (Abstract truncated at 2000 characters).
Descriptors		DEATH, SUDDEN, CARDIAC DEFIBRILLATORS, IMPLANTABLE HEART ARREST HEART FAILURE, CONGESTIVE TACHYCARDIA, VENTRICULAR