<International Circulation>:When it comes to ICDs， how do you avoid and manage the complications that come with it?

  《国际循环》：植入 ICDs后，您如何避免以及管理随之而来的并发症？

    Dr Iwai:  The complications from ICDs obviously include the surgical complications and long-term， these are mainly due to infection. It is a difficult population to deal with but certainly these are patients with poor wound healing due to chronic steroid use or diabetes in whom adjunctive measures such as antibiotic coated pockets around the device can be helpful. In addition， patients can have inappropriate ICD shocks which are quite common in any of the randomized trials and awareness of this and some of the newer capabilities of defibrillators coming out can help to decrease the incidence of this. An inappropriate shock is a shock delivered by the device for an arrhythmia it thinks is ventricular in origin. Most commonly inappropriate shocks are due to atrial fibrillation with rapid ventricular rates or other supraventricular tachyarrhythmias. Less commonly， inappropriate shocks can be due to lead noise from electromagnetic interference or lead fracture.

    Iwai博士： ICDs的并发症包括手术并发症和长期并发症，主要源自感染。对于长期服用类固醇或有糖尿病而伤口愈合欠佳的患者，辅助措施如装置周围的抗生素涂层袋可能有帮助。另外，任一项随机试验均证实，ICD可出现相当常见的I不适当放电。目前已经认识到这一点，ICD的某些新功能可能有助于降低此种现象的发生率。不适当放电是由装置误认为有源于心室的心律失常，最常见的是心房颤动伴快速心室率或其他室<