1、ContentsHistory of ICDsPioneer of ICD Technology1985-First approved ICDVentak is a trademark of Cardiac Pacemakers,Inc.The next milestone for ICDsPectoral implants approved by the FDA in 2019More comfortable for patientsFaster implantsSmaller but just as powerful as older devices“Active Can”Technolo
2、gyTraditionalSystemRV-CanEvolution of ICD Technology19912019The First ICDs FeaturedEpicardial LeadsTransvenous Leadsand Advanced TherapyIncrease Effectivenessof ICD TherapyPectoral ICDsReduce Costs andIncrease Surgical Ease1985“Dual Chamber”ICDsBasic Functions of ICDHow it works Auto-Adjusting Sensi
3、tivityPost-sensedsensitivity adjustmentPost-pacedsensitivity adjustmentProgrammed sensitivityPost-pace blankingMarker Channel TelemetryVPACEVPACEVSENSEVPACEVSENSERectifiedEGMChanging ThresholdPost-PacePost-Sense10 x4.5x0.3 mVThree Zone DetectionVT DetectionVFFVTVTDetection Status:ONOFFONInterval(ms)
4、:320400Initial NID:12/1612Sensitivity(mV):0.3VT Counter Value:123456789101112200 msVSVSVSVSVSTSTSTSTSTSTSTSTSTSTSTSTDVF DetectionFVT Detection via VF CounterTFTF121110987654321TFTFTFTFTFTFTFTFTFTFVSVSVSVSVSLOOKBACK WINDOW(8 INTERVALS BEFORE NID)FVT Detection via VT Counter121110987654321LOOKBACK WIN
5、DOW(8 INTERVALS BEFORE NID)VSVSVSTSTSTSTSTSTSTSTSTSTFTSTFVF Counter:Increased VT Detection SpecificitySinus TachycardiaAtrial TachycardiaAtrial FlutterAtrial FibrillationMorphologyXXXXOnset XStability XTherapiesBurst Ramp Ramp+ICD Indications,who gets one or notGregoratos G.J Am Coll Cardiol.2019;31
6、:1175-1209.2019 Class I Indications for ICD TherapyGregoratos G.J Am Coll Cardiol.2019;31:1175-1209.2019 Class II IndicationsGregoratos G.J Am Coll Cardiol.2019;31:1175-1209.2019 Class II Indications(cont.)Gregoratos G.J Am Coll Cardiol.2019;31:1175-1209.2019 Class III IndicationsGregoratos G.J Am Coll Cardiol.2019;31:1175-1209.2019 Class III Indications(cont.)Gregoratos G.J Am Coll Cardiol.2019;31:1175-1209.Implant Procedure
