Schmitt C, Brachmann J, Saggau W, Beyer T, Waldecker B, Scharowski K, Hilbel T, Montero M, Offner B, Schöls W
Medizinische Universitäts-Klinik Heidelberg.
Z Kardiol. 1991 Nov;80(11):665-72.
In 41 patients with recurrent sustained ventricular tachycardia and/or ventricular fibrillation an integrated pacemaker-defibrillator-system (PCD, Medtronic, model 7216 A or 7217 B) was implanted. In 21 out of 24 (88%) patients a new transvenous implantation technique in combination with a subcutaneous patch electrode was used. The implanted devices comprise antibradycardiac pacemaker functions, two different forms of antitachycardiac pacemaker functions (ramp and burst pacing), and internal cardioversion or defibrillation capabilities. During a mean follow-up of 8 months 147 episodes of ventricular tachycardia were detected, 131 of them were terminated successfully by antitachycardiac pacing; in 13 episodes internal cardioversion was applied to revert ventricular tachycardia. Twenty-seven episodes of ventricular fibrillation or rapid ventricular tachycardia (greater than 200/min) were detected and successfully terminated by internal defibrillation. In six patients with intermittent rapid atrial fibrillation, change of antiarrhythmic therapy was required to avoid activation of the device. The new integrated pacemaker-defibrillator systems improve therapy in patients with life-threatening tachyarrhythmias by reducing the number of internal cardioversions/defibrillations; the non-thoracotomy approach reduces the post operative risk.
对41例复发性持续性室性心动过速和/或心室颤动患者植入了一体化起搏器-除颤器系统（PCD，美敦力公司，7216 A型或7217 B型）。24例患者中有21例（88%）采用了经静脉植入新技术并结合皮下贴片电极。植入装置包括抗心动过缓起搏器功能、两种不同形式的抗心动过速起搏器功能（斜坡式和猝发式起搏）以及体内心脏复律或除颤功能。在平均8个月的随访期间，检测到147次室性心动过速发作，其中131次通过抗心动过速起搏成功终止；13次发作采用体内心脏复律来恢复窦性心律。检测到27次心室颤动或快速室性心动过速（大于200次/分钟）并通过体内除颤成功终止。6例间歇性快速心房颤动患者需要改变抗心律失常治疗以避免装置激活。新型一体化起搏器-除颤器系统通过减少体内心脏复律/除颤次数改善了对危及生命的快速心律失常患者的治疗；非开胸方法降低了术后风险。
