Cesario David, Bhargava Mandeep, Valderrábano Miguel, Fonarow Gregg C, Wilkoff Bruce, Shivkumar Kalyanam
UCLA Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1679, USA.
J Cardiovasc Electrophysiol. 2004 Jul;15(7):780-3. doi: 10.1046/j.1540-8167.2004.03649.x.
High defibrillation thresholds (DFTs) occasionally are encountered during placement of implantable cardioverter defibrillators (ICDs). There are multiple strategies to lower DFTs in such patients, including reassessment of right ventricular lead position, alteration of the shock waveform, and implantation of subcutaneous arrays. This article describes a novel technique of implanting a high-voltage lead in the azygos vein. This procedure may serve as an adjunctive approach to reduce DFTs. The anatomic location of the azygos vein posterior to the heart provides a suitable shocking vector between the right ventricular electrode, a high-voltage lead placed in the azygos vein, and the ICD can.
在植入式心脏复律除颤器（ICD）植入过程中，偶尔会遇到高除颤阈值（DFT）。对于这类患者，有多种降低DFT的策略，包括重新评估右心室导线位置、改变电击波形以及植入皮下阵列。本文介绍了一种在奇静脉中植入高压导线的新技术。该手术可作为降低DFT的辅助方法。心脏后方奇静脉的解剖位置在右心室电极、置于奇静脉的高压导线与ICD罐之间提供了合适的电击向量。
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