作者简介： 张锦涛，1976.09 四川都江堰市 主管护师，本科，内科【摘要】目的 扩张型心肌病死亡可发生于疾病的任何阶段。病死率较高，慢性心衰和恶性心律失常是导致患者发生心脏性猝死的主要原因。ICD，CRT-D不仅能有效地改善心衰患者的症状、运动耐量、生活质量，还能有效地降低患者的住院率和心力衰竭死亡率,。 方法;对两例植入起搏除颤器患者与评估、计划、实施，给予有效的护理。结果结论 植入前做好沟通，做好手术的评估，保证病员术中情绪稳定，做好植入后的护理，防止起搏器囊袋感染，保证电极的稳固连接，起搏器功能正常。

    【关键词】ICD，CRT-D, 扩张型心肌病, 心衰和恶性心律, 心脏性猝死

    【Abstract】Death could be resulted at any stage of an expansionary cardiomyopathy. It has high case fatality rate. Chronic heart failure and m alignant arrhythmia are the main reasons to cause sudden cardiac death. ICD, CRT-D can not only reduce the symptoms in patients with heart failure effectively, physical exercise tolerance and life quality, but also reduce the rate of hospitalization and mortality in patients with heart failure. Before the implantation of ICD, CRT-D, it is nessisary to make good communication with pacients, to do surgery assessment and to ensure the operation of emotional stability. In the same time, make a better nursing after the implantation, prevent infection from the pacemaker pocket, ensure the stable connection between the electrodes and the normal function of pacemaker. ......