Bennett Matthew T, Tung Stanley K K
Division of Cardiology, University of British Columbia, Vancouver, Bristish Columbia, Canada.
J Long Term Eff Med Implants. 2010;20(3):187-202. doi: 10.1615/jlongtermeffmedimplants.v20.i3.30.
Cardiac pacemakers and implantable cardioverter/defibrillators are becoming more common due to expanded indications and increasing patient survival. In addition, these device systems are being implanted in younger patients, which increases their necessity for long-term durability. Device adverse events can be seen early, during or following implantation (perforation, lead dislodgement, infection), or late (lead fraction, insulation failure or device system infection). These adverse events can, at least in part, be attributed to intrinsic device system structure. Since the initial pacemakers and implantable cardioverter/defibrillators, many modifications in both device system hardware and software have been made to enhance both their durability and function. The current era of devices appear to have made adjustments for previous inadequacies and promise to be reliable and to function well. Despite this, however, it is necessary for clinicians to be aware of possible malfunctions, their warning signs, and the appropriate course of action should these malfunctions be encountered. In this review we describe the common device system malfunctions and device system insertion complications.
由于适应症的扩大和患者生存率的提高，心脏起搏器和植入式心脏复律除颤器正变得越来越普遍。此外，这些设备系统正被植入更年轻的患者体内，这增加了它们对长期耐用性的需求。设备不良事件可在植入早期、植入期间或植入后出现（穿孔、导线移位、感染），或在后期出现（导线断裂、绝缘故障或设备系统感染）。这些不良事件至少部分可归因于设备系统的固有结构。自最初的起搏器和植入式心脏复律除颤器以来，设备系统的硬件和软件都进行了许多改进，以提高其耐用性和功能。当前的设备时代似乎已经针对以前的不足进行了调整，并有望可靠且运行良好。然而，尽管如此，临床医生仍有必要了解可能出现的故障、其警示信号，以及遇到这些故障时应采取的适当行动。在这篇综述中，我们描述了常见的设备系统故障和设备系统植入并发症。
