<International Circulation>: With dual chamber ICDs as opposed to single chamber ICDs， recent studies have shown that dual chamber ICDs resulted in more complications and mortality.  In spite of this， dual chamber ICDs seem to be used more often.  Do you have a comment on this apparent conundrum?

   《国际循环》：采用双腔心脏除颤器也就等于不使用单腔心脏除颤器，最近的研究显示，双腔心脏除颤器能够导致更多的并发症并使死亡率升高。尽管如此，双腔心脏除颤器的使用似乎更加常见。您对这种明显的难题能够做一下评论吗？
 
    Prof. Thomas Dewland: There is much more to be learned about the use of single versus dual chamber ICDs.  In our study that you are referring to， after adjusting for multiple co-morbidities， that patients receiving dual chamber ICDs had higher rates of complications as opposed to those receiving single chamber ICDs.  I want to stress that there are certainly appropriate uses for dual chamber ICDs.  The study only looked at the up-front complications through hospital discharge so it remains to be seen whether longer follow-up will reveal similar differences between the two types of the device.  The study was one of the first to show that the devices are not equal with regard to the risk of complications.  It is important for the physician to consider the differences in risk associated with these devices and whether the patient’s condition necessitating ICD warrants this small， seemingly real risk.  

    Dewland教授：对于单腔和双腔心脏除颤器的使用还需要进一步了解。在您提到的那项研究中，经过多元并发症的调整，接受双腔心脏除颤器的患者比接受单腔心脏除颤器的患者并发症的发病率高。我在这里想强调一下，双腔心脏除颤器具有确定的适当用法。这一研究只观察了出院前期并发症的发病率，而对于这两种类型的仪器在更长期的随访中的表现是否一致，还需要进一步观察。对于并发症发病率的比较，这一研究首次显示了两种仪器的表现并不相同。对于医师们来说，考虑到这类仪器相关风险的不同是很重要的，判断患者的情况是否必须接受ICD治疗似乎很有风险。

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