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植入式心脏复律除颤器终止电击诱发的心室颤动

Termination of electrocution-induced ventricular fibrillation by an implantable cardioverter defibrillator.

作者信息

Ginwalla Mahazarin, Battula Smitha, Dunn Jonathan, Lewis William R

机构信息

Department of Cardiology, Metrohealth Campus, Case Western Reserve University, Cleveland, Ohio, USA.

出版信息

Pacing Clin Electrophysiol. 2010 Apr;33(4):510-2. doi: 10.1111/j.1540-8159.2009.02607.x. Epub 2009 Dec 10.

Abstract

We describe a case in which an implantable cardioverter defibrillator (ICD) saved a patient's life after he tried to commit suicide by electrocuting himself. Deaths caused by electrocution are usually accidental and rarely suicidal. The amount of current flow is the most important factor in deciding the degree of electrical injury, which may range from transient muscle tremors to death. The ICD is electrically insulated from surrounding electromagnetic interference and the passage of electric current typically does not damage or reprogram the device. In our patient, electromagnetic interference caused by the electric current initially triggered the noise reversion mode, leading to asynchronous pacing. Ventricular fibrillation was detected and terminated only after the electromagnetic interference stopped, as depicted by the intracardiac electrogram. This case is the first documented example of an ICD-aborted fatal electrocution from ventricular fibrillation caused by an unnatural electrical source. (PACE 2010; 510-512).

摘要

我们描述了这样一个病例

一名患者试图触电自杀,而植入式心脏复律除颤器(ICD)挽救了他的生命。触电致死通常是意外事故,很少是自杀行为。电流流量是决定电损伤程度的最重要因素,电损伤程度从短暂的肌肉震颤到死亡不等。ICD与周围的电磁干扰电绝缘,电流通过通常不会损坏该设备或对其重新编程。在我们的患者中,电流引起的电磁干扰最初触发了噪声反转模式,导致异步起搏。如心内电图所示,仅在电磁干扰停止后才检测到并终止了心室颤动。该病例是首例有记录的因非自然电源导致心室颤动,ICD中止致命触电的案例。(《PACE》2010年;第510 - 512页)

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