Pavlović Sinisa, Milasinović Goran, Zivković Mirjana
School of Medicine, University of Belgrade.
Acta Chir Iugosl. 2011;58(2):25-9. doi: 10.2298/aci1102025p.
Application of cardiac electrostimulation in strictly defined indications has been on the increase over the last few decades. Frequent use of this therapy as well as the fact that it is applied predominantly in patients in the seventh decade of life, implies possible signifficant comorbidities and need for various diagnostic and surgical procedures. These are the reasons we decided to point out certain specific features in approaching this patient group in preparation and implementation of these procedures. Preoperative approach starts with usual patient history, with additional information on the type of pacemaker, last pacemaker check and electrocardiogram. This general approach is not substantialy different for pacemaker or ICD patients. What is specific is the possible interferrence caused by devices used in diagnostic or therapeutic procedures (diathermy, lithotripsy). Complications that may arise are usually related to the underlying disease rather than the pacemaker malfunction, but still, careful approach and pacemaker check are warranted, especially in the group marked as "pacemaker dependent". Adequate preoperative assessment, only slightly different from the usual, represents a sufficient guarantee for safe procedures diagnostic, therapeutic or surgical.
在过去几十年中，心脏电刺激在严格限定的适应症中的应用一直在增加。这种治疗方法的频繁使用以及它主要应用于七十岁左右的患者这一事实，意味着可能存在显著的合并症以及对各种诊断和外科手术的需求。这些就是我们决定指出在为这一患者群体准备和实施这些手术时的某些特定特征的原因。术前方法始于常规的患者病史采集，并补充有关起搏器类型、上次起搏器检查和心电图的信息。对于起搏器患者或植入式心脏除颤器（ICD）患者，这种一般方法没有实质性差异。特殊之处在于诊断或治疗过程中使用的设备（电灼、碎石术）可能造成的干扰。可能出现的并发症通常与基础疾病有关，而非起搏器故障，但即便如此，仍需谨慎对待并进行起搏器检查，尤其是在“依赖起搏器”的患者群体中。充分的术前评估与常规评估仅有细微差异，是诊断、治疗或外科手术安全进行的充分保障。
