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程序性警报预测植入式心律转复除颤器(ICD)导线故障的局限性。

Limitation of programmed alerts to predict ICD lead failures.

作者信息

Vlay Stephen C

机构信息

Stony Brook Arrhythmia Study and Sudden Death Prevention Center, Division of Cardiology, Department of Medicine, Stony Brook University, Stony Brook, New York 11794, USA.

出版信息

Pacing Clin Electrophysiol. 2009 Apr;32(4):554-5. doi: 10.1111/j.1540-8159.2009.02321.x.

DOI:10.1111/j.1540-8159.2009.02321.x
PMID:19335870
Abstract

A 75-year-old man with a Sprint Fidelis ICD lead (Medtronic Inc., Minneapolis, MN, USA) experienced inappropriate shocks after sudden failure of the right ventricular (RV) pace-sense connector resulting in noise. Interrogation of the implantable cardioverter-defibrillator pulse generator revealed that the 3 AM daily measurement of RV pacing impedance was slightly higher (750 Omega) than the baseline (approximately 450-550 Omega)(although below the recommended alert level of 1,000 Omega) and markedly higher at 4 AM (1,552 Omega) when therapies were delivered. The event occurred before the patient could be alerted by the audible tones. Thus, the manufacturer's recommended impedance monitoring alert parameters will not predict all lead failures.

摘要

一名植入美敦力公司(美国明尼阿波利斯)Sprint Fidelis ICD导线的75岁男性,在右心室(RV)起搏感知连接器突然失灵并产生噪音后,经历了不适当的电击。对植入式心脏复律除颤器脉冲发生器的问询显示,每日凌晨3点测量的RV起搏阻抗略高于基线(约450 - 550Ω)(尽管低于推荐的1000Ω警报水平),为750Ω,而在凌晨4点进行治疗时则显著升高至1552Ω。该事件发生在患者能够被可听音调警报之前。因此,制造商推荐的阻抗监测警报参数并不能预测所有导线故障。

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引用本文的文献

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Contributions of remote monitoring to the follow-up of implantable cardioverter-defibrillator leads under advisory.远程监测对建议性植入式心脏转复除颤器导线随访的贡献。
Eur Heart J. 2010 Sep;31(18):2246-52. doi: 10.1093/eurheartj/ehq203. Epub 2010 Jun 30.