AL-Dashti Raja, Huynh Thao, Rosengarten Michael, Page Pierre
Division of Cardiology, McGill University, Montreal, Quebec.
Can J Cardiol. 2002 Aug;18(8):887-90.
Transvenous pacemaker malposition in the systemic circulation is a rare complication of pacemaker implantation; the incidence is not well known. However, with the aid of two-dimensional echocardiography, the problem of pacemaker malposition can be identified earlier. After pacemaker insertion, an electrocardiogram and a posterior-anterior and lateral chest x-ray should be routinely performed. In difficult cases, transthoracic echocardiography and transesophageal echocardiography can be helpful for better visualization and confirmation of the malposition of the pacemaker lead(s). Pacemaker infection is another complication. A case of pacer lead malposition into the left ventricle through a sinus venosus atrial septal defect and superimposed infection is reported, and the management of endocardial lead malposition in the systemic circulation and pacemaker infection is reviewed.
经静脉起搏器在体循环中位置异常是起搏器植入的一种罕见并发症；其发生率尚不清楚。然而，借助二维超声心动图，可以更早地发现起搏器位置异常问题。起搏器植入后，应常规进行心电图以及后前位和侧位胸部X线检查。在疑难病例中，经胸超声心动图和经食管超声心动图有助于更好地观察和确认起搏器导线位置异常。起搏器感染是另一种并发症。本文报告了1例通过静脉窦型房间隔缺损导致起搏器导线移位至左心室并叠加感染的病例，并对体循环中心内膜导线位置异常及起搏器感染的处理进行了综述。
