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1 1133

2 implantable cardioverter-defibrillator, ICDcardiac resynchronization therapy, CRT CRTICD CRT-D QOL QOL IH 1134

3 % % <25% <30% <9% <3.0 <2.5 < % 30 49% 9 10% % 50 69% 11 12% % 70 89% 13 16% % 90% >16% % 100% 20%

87.1 4.55.9 3.64.7 60 84% 70 89% 13 16% 7.210.1 6.08.4 4.86.7 85% 90% >16% 10.2 8.5 6.8 100% 100% 20% 12.

4 ICD ICD ICD ICD CRT g g EMIElectromagnetic Interference

5 IH IH EASIH cm EAS EAS EAS a Irnich.V A mvpppeakto-peak A A. ma b c EMI m kv/m JR, V, V m JR 1137

6 IC X X 2 P N PN a C-MOS IC bpn PN ICPN X X X X InSyncCT X InSyncThera-i X X X X ICX X X C-MOS IC X X 1138

7 ICD ICD CRTCRT CRT-P CRT-D ICD 1139

8 1 2 3 ICD ICD ICDCRT-D

9 表 6 学校生活管理指導表小学生用ペースメーカ ICD CRT を受けた患者の社会復帰就学就労に関するガイドライン 1141

10 表 7 学校生活管理指導表中学高校生用循環器病の診断と治療に関するガイドライン年度合同研究班報告 1142

11 1143.

13 A B C D

14 1146

15 1147 HIV B..

16 ICD ICD ICD ICD ICD ICD ICD ICD 5 ICD 1148

17 1149 ICD PM ICD PMICD

18 ICD ICD ICD ICD CRT-PCRT-D CRT ICD ICD ICD ICD ICD ICD ICD ICD ICD.. ICD ICD CRT-D acceleration shock shockicd Brugada ICDCRT-D ICD ICD ICD ICD ICD ICD 1150

19 ICD ICD ICD ICD ICD ICD ICD ICD ICD ICD ICDCRT-D ICD AHA Heart Rhythm Society ICD ICD ICD EMI cm cm. cm PHS PHS MHz.GHz PDC PHS.GHz FOMA W-CDMA 1151

20 GHz cdmaone CDMA/CDMA x MHzPDC W-CDMACDMA/CDMA x ICD cm MHz W-CDMA cm 10 A mv A ICD A ma 1 22cm 22cm 22cm 2 30cm 22cm 30cm ICD ICD IH IH IH IH cm ONOFF 1152

21 cm cm m kv/m kv/m kv A ICD EMI IH IH cm EAS CD RFID EMI 6AB EAS/RFID m RFID

22 RFID cm RFID cm JR JR cm cm IS: Implants for surgery - Active implantable medical devices ICD Hz.G G ms...,m,m,m,m,m. m m m 1154

23 m 11 : 12 A B C 1155

24 6 6 64Hg Hg 3050Hg A B Fallot AB AB C ICD Heart Rhythm Society ICD ICD ICD ICD IAB AB ICD ICD ICD ICD ICD ICD QT Brugada QT AB A 1156

25 ICD ICD ICD C-MOS IC IC c XIC ICPN X IC ICXX X X IC IC cm AOO/VOO/DOO MRI EMIMRI FDA MRI MRI X CTX 1157

26 X X AOO/VOO/DOO ICD OFF X X m EMI cm EMI cm MRI MRI X CTX X cm IcFlecainide Pilsicainide Ia amiodarone 1158

27 amiodarone ICD amiodarone ICD ICD ICD ICD ICD ICD ICD ICD Relative Risk.- ICD ICD ICD ICD ICD QT ICD Torsades de Pointes ICD CRT 1159

28 IH IH ICD D 13 QT. 14 E QTLQTICD 141, ,755 24, , , , , 1160

29 E 61 E 61 D 13 E 36 D E D E 16 A,B C D E C D E 13 D E 16 D E EE 16 D E 16 EE 61 C,D E B,C D A B E 1 QT E 1 B C D C,D E WPW E 13 PR E 13 1 PR PR PR E Wenckebach 1 E 13 2 EE 61 MobitzII 2 D E 36 2 C D 36 C Adams-Stokes A,B C D E 36 CD Adams-Stokes A,B C 1161

30 ICD 15 CRT EE D E B CDE 141, ,755 24, , , , 1162

31 ICD QOL 16 ICD CRT mmhg 95 mmhg

32 17 ICD CRT-D ICD, CRT-D ICD CRT-D ICD ICD ICD ICD AHA Heart Rhythm Society ICD AHA/ NASPE 1164

33 ICD AHA/NASPE ICD 8 9 ICDCRT-D 1165

34 a b c d e ICDCRT-D 18 ICDCRT-D 19CRT 20 ICD ICDCRT-D21 ICD ICD ICD ICD ICD ICD ICD 1166

35 OA TIGMIGMAGCO 2 PCLAN ICD ICD ICDCRT-D ICDCRT-D NYHA 10 electrical storm Electrical storm ICDCRTCRT-D 22 NYHA ICD LVEF 0.20 to no CHF CHF Class 1167

36 ICD * * * * CRT CRT-D * * *electrical storm JR 1168

37 23 ILO fitness 24 impairment disability handicap

38 adaptation 1170

39 . Circulation Journal Vol., Suppl. IV,, p-. B a l a d y G J, C h a i t m a n B, D r i s c o l l D, e t a l. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Circulation ; : -. p-. QT ; : -.. European Heart Failure Training Group. Experience from controlled trials of physical training in chronic heart failure. Protocol and patient factors in effectiveness in the improvement in exercise tolerance. Eur Heart J ; : -. Sullivian MJ, Hiiginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction: Hemodynamic and metabolic effects. Circulation ; : Mahler DA, Floelicher VE, Miller NH, et al. General Principles of Exercise Prescription. In ACSM s GUIDELINES FOR EXERCISE TESTING AND PRESCRIPTION, th Ed., American College of Sports Medicine, ed by Kenney WL, pp-, Williams & Wilkins,. Tei C, Horikiri Y, Park JC, et al. Acute hemodynamic improvement by thermal vasodilation in congestive heart failure. Circulation ; : -. ; : -. Irnich W, de Bakker M T and Bisping H J. Electromagnetic interference in implantable Pacemakers. PACE ; : -... Adamec R, Haefliger JM, Killisch J, Niederer J and Jaquet P. Damaging effect of therapeutic Radiation on programmable pacemakers. PACE ; : -.. Blamires NG, Myatt J. X-ray effects on pacemaker type circuits. PACE ; : -.. ; : pp Sears SF, Todaro JF, Urizar G. et al. Assessing the psychosocial impact of the ICD: a national survey of implantable cardioverter defibrillator health care providers. PACE ; : Epstein AE, Miles WM, Benditt DG, et al. Personal and public safety issues related to arrhythmias that may affect consciousness: implications for regulation and physician recommendations. A medical/scientific statement from the American Heart Association and the North American Society of Pacing and Electrophysiology. Circulation ; : -. Ikeguchi S, Peters NS. Implantable cardiac defibrillator and motor vehicle driving; Present status in North America and Europe / Consideration with relevance to Japanese new statements on the present issue. J Arrhythmia ; : -. ICD ICD. ; : -. Epstein AE, Baessler CA, Curtis AB, et al. Addendum to 1171

40 Personal and public safety issues related to arrhythmias that may affect consciousness: implications for regulation and physician recommendations. A medical/scientific statement from the American Heart Association and the North American Society of Pacing and Electrophysiology. Circulation ; : -.. ; : : -,..... ISO -. Implants for surgery Active implantable medical devices, Part. General requirements for safety, marking and for information to be provided by the manufacturer. ISO -. Implants for surgery Active implantable medical devices, Part. Cardiac pacemakers. CEN/CENELEC. European standard pren --: Active implantable medical devices, Part -. Particular requirement for active implantable medical devices intended to treat tachyarrhythmia (Includes implantable defibrillators).. -. Maron BJ, et al. Introduction: eligibility recommendations for competitive athletes with cardiovascular abnormalitiesgeneral considerations. J Am Coll Cardiol. ; : -... Circ J ; (suppl IV): -. Heidbuchel H, et al. Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions Part I: Supraventricular arrhythmias and pacemakers. Eur J Cardiovasc Prev Rehabil. ; : -.. Mitchell JH, et al. Task Force : classification of sports. J Am Coll Cardiol. ; : -.. Pelliccia A, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. ; : -.. Heidbuchel H, et al. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions. Part II: ventricular arrhythmias, channelopathies and implantable defibrillators. Eur J Cardiovasc Prev Rehabil. ; : -.. Lampert R, et al. Safety of sports participation in patients with implantable cardioverter defibrillators: a survey of heart rhythm society members. J Cardiovasc Electrophysiol. ; : -.. Maron BJ, et al. Task Force : HCM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. J Am Coll Cardiol. ; : -.. Thompson PD, et al. Task Force : coronary artery disease. J Am Coll Cardiol. ; : -. Medtronic: ENRHYTHM TM PDR Reference Manual. Duru F, Luechinger R, Scheidegger MB, Lüscher TF, Boesiger P and Candinas R. Pacing in magnetic resonance imaging environment: Clinical and technical considerations on compatibility. European Heart Journal ; : -.. Heys DL, Holmes DR Jr, Gray JE. Effect of. tesla nuclear magnetic resonance imaging scanner on implanted permanent pacemakers. JACC ; : -.. Fontaine JM., Mohamed FB, Gottlieb C, Callans DJ, and Marchlinski FE. Rapid Ventricular Pacing in a Pacemaker Patient Undergoing Magnetic Resonance Imaging. PACE ; : -.. Anfinsen O-G, Berntsen RF, Aass H, Kongsgaard E, and Amlie JP. Implantable Cardioverter Defibrillator Dysfunction During and After Magnetic Resonance Imaging. PACE ; : -.. Fiek M, Remp T, Reithmann C, and Steinbeck G. Complete loss of ICD programmability after magnetic resonance imaging. PACE ; : l-.. Avery JE. Loss prevention case of the month: not my responsibility! J Tenn Med Assoc ; :.. Faris OP and Shein MJ. Government Viewpoint: U.S. Food & Drug Administration: Pacemakers, ICDs and MRI. PACE ; : -.. Faris OP and Shein MJ. Food and Drug Administration Perspective, Magnetic resonance imaging of pacemakers and implantable cardioverter-defibrillator patients. Circulation ; : -.. No.X CT. Cooper D, Wilkoff B, Masterson M, Castle L, Belco K, 1172

41 Simmons T, Morant V, Streem S, and Maloney J. Effects of Extracorporeal Shock Wave Lithotripsy on cardiac Pacemakers and its Safety in Patients with Implanted Cardiac Pacemakers. PACE ; : -.. -,. Kang TS, Yoon YW, Park S, Hong B, Kim D, Kwon HM, Kim H. A case of acute ventricular capture threshold rise associated with flecainide acetate. Yonsei Med J,,, -. Numata T, Abe H, Nagatomo T, Kohshi K, Nakashima Y. Ventricular pacing failure after a single oral dose of pilsicainide in a patient with a permanent pacemaker and paroxysmal atrial fibrillation. Pacing Clin Electrophysiol,,, -. Schuchert A, Meinertz T. Acute effects of a class IA antiarrhythmic drug on the ventricular evoked response amplitude in patients with cardiac pacemakers. Cardiology,,, -. Brode SE, Schwartzman D, Callans DJ, Gottlieb CD, Marchlinski FE. ICD-antiarrhythmic drug and ICDpacemaker interactions. J Cardiovasc Electrophysiol,,, -. Dorian P, Newman D. Effect of sotalol on ventricular fibrillation anddefibrillation in humans. Am J Cardiol. ; : A-A.. Hohnloser SH, Dorian P, Roberts R, Gent M, Israel CW, Fain E, Champagne J, Connolly SJ. Effect of amiodarone and sotalol on ventricular defibrillation threshold: the optimal pharmacological therapy in cardioverter defibrillator patients (OPTIC) trial. Circulation,,, -. Kolb C, Schmieder S, Lehmann G, Zrenner B, Karch MR, Plewan A, Schmitt C. Do airport metal detectors interfere with implantable pacemakers or cardioverter-defibrillators? J Am Coll Cardiol ; : -.. Madrid A, Sanchez A, Bosch E, Fernandez E, Moro Serrano C. Dysfunction of implantable defibrillators caused by slot machines. Pacing Clin Electrophysiol ; : -.. Steinke EE. Intimacy needs and chronic illness: strategies for sexual counseling and self-management. J Gerontol Nurs ; : Van Kuilenburg JT, Smeets JL. Diagnostic image (). A man with a painful axilla. Ned Tijdschr Geneeskd :,.. -. Batra AS, Silka MJ. Mechanism of sudden cardiac arrest while swimming in a child with the prolonged QT syndrome. J Pediatr : -,. Moraga FA, Osorio JD, Vargas ME. Acute mountain sickness in tourists with children at Lake Chungara ( m) in northern Chile. Wilderness Environ Med : -,. Lee AP, Yamamoto LG, Relles NL. Commercial airline travel decrease oxygen saturation in children. Pediatr Emerg Care : -,. -.. DeMaso DR, Lauretti A, Spieth L, et al. Psychosocial factors and quality of life in children and adolescents with implantable cardioverter-defibrillators. Am J Cardiol : -,. -. ; : -. Q&A. p-. /ICD pp-. /ICD pp-. p-. Levine JH, Mellits ED, Baumgardner RA, et al. Predictors of first discharge and subsequent survival in patients with automatic implantable cardioverter-defibrillators. Circulation ; : -.. Kim SG, Fischer JD, Choue CW, et al. The influence of left ventricular function on the outcome of patients treated with implantable defibrillators. Circulation ; : -.. Grimm W, Flores BT, Marchlinski FE. Shock occurrence 1173

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C/NC : committed/noncommitted

C/NC : committed/noncommitted 110 time post-icd implant 1) The Cardiac Arrhythmia Suppression Trial (CAST) Investigators Preliminary report : Effect of encainaide and flecainide on mortality in a