一項涉及了12個國家73個單位的大規(guī)模研究發(fā)現(xiàn)：植入式心律復(fù)律除顫器治療并不能夠降低近期有過心臟病發(fā)作高危患者的總體死亡率，但是該研究也發(fā)現(xiàn)植入式心律復(fù)律除顫器顯著降低心律不齊患者的死亡率。

該研究得到了St. Jude醫(yī)療公司(St. Paul, MN, USA)的資助，項目叫做DINAMIT(除顫器在急性心肌梗塞患者中的臨床試驗)。入選患者年齡在18歲～80歲之間，入選標準為6天～40天內(nèi)有心臟病發(fā)作、左心室射血分數(shù)小于等于35％以及出現(xiàn)心肌自主調(diào)節(jié)損害癥狀。這些研究結(jié)果發(fā)表在2004年11月9日的《新英格蘭醫(yī)學期刊》。

盡管研究結(jié)果顯示總死亡率沒有下降，研究人員也證實了在這個患者群體中，植入式心律復(fù)律除顫器治療能夠顯著降低那些近期心臟病發(fā)作的患者的猝死以及高危心率不齊患者的死亡風險。St. Jude醫(yī)療公司是植入式心律復(fù)律除顫器的研發(fā)者和市場推廣者。

該研究項目首席研究員、J.W. Goethe大學(Frankfurt, Germany)醫(yī)學教授Stefan H. Hohnloser醫(yī)生說：“盡管DINAMIT研究項目中，植入式心律復(fù)律除顫器治療與心率不齊導(dǎo)致的死亡率顯著下降相關(guān)，但是卻被非心率不齊導(dǎo)致死亡率的升高所抵消。”

Study Finds Limitation to ICD Benefit
 
A large study involving 73 sites in 12 countries has found that implantable cardioverter defibrillator therapy does not reduce overall mortality in high-risk patients who have recently had a heart attack, but the study also found that ICDs significantly reduced mortality in patients with arrhythmia.

The study, sponsored by St. Jude Medical, Inc. (St. Paul, MN, USA), was called DINAMIT (defibrillator in acute myocardial infarction trial). Patients in the study ranged in age from 18-80, with additional inclusion criteria being a heart attack within six to 40 days, a left-ventricular ejection fraction of less than or equal to 35%, and signs of impaired cardiac autonomic modulation. The results were reported in the December 9, 2004, issue of The New England Journal of Medicine.

While the results showed no reduction in total mortality, they also demonstrated that in this patient population, ICD therapy can significantly reduce the risk of sudden death in patients who have had a recent heart attack and are at high risk of arrhythmic death. St. Jude Medical is a developer and marketer of ICDs.

“Although ICD therapy in the DINAMIT study was associated with a large, statistically significant reduction in the rate of death due to arrhythmia, it was offset by an increase in the rate of death from nonarrhythmic causes,” commented Stefan H. Hohnloser, M.D., professor of medicine, J.W. Goethe University (Frankfurt, Germany), and one of the principal investigators.