7. Имплантируемые кардиоверторы-дефибрилляторы (icd)

1. ICD обычно имплантируют в лабораториях электрофизиологии пациентам, страдающим желудочковой тахикардией или другими жизненнопасными аритмиями. Обычно пациенты сохраняют свой антиаритмический лекарственный режим, поскольку почти половина из них требует медикаментозного контроля своих аритмий.⁴⁷

2. Когда ICD устройство имплантируют в операционной во время операции, в раннем послеоперационном периоде его обычно оставляют в неактивной форме. Различные нарушения, в том числе – газов крови, кислотно-основного баланса, жидкостные и электролитные нарушения, а также различные лекарственные назначения могут изменять тенденцию развития аритмий, способных запускать эти устройства и расходовать батарейную емкость. В госпитальных условиях следует отдавать предпочтение легкодоступным внешним дефибрилляторам. Перед выпиской из стационара, в лаборатории ЭФ, имплантированное пациенту ICD-устройство ретестируют и активируют. У изголовья госпитальной кровати пациента должна быть размещена карточка, указывающая любому, прибывшему на экстренный вызов, активировано устройство или нет.

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