Yamada Takumi, Robertson Peter G, McElderry H Thomas, Doppalapudi Harish, Plumb Vance J, Kay G Neal
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294-0019, USA.
Pacing Clin Electrophysiol. 2012 Jun;35(6):e173-6. doi: 10.1111/j.1540-8159.2012.03332.x. Epub 2012 Feb 23.
A 72-year-old man with nonischemic cardiomyopathy was referred because his implantable cardioverter defibrillator had failed to terminate spontaneous ventricular fibrillation (VF). Defibrillation threshold (DFT) testing confirmed that 830-V shocks failed to defibrillate VF despite optimization of the biphasic waveform and reversal of shock polarity. The placement of a new right ventricular lead and the addition of a subcutaneous array failed to defibrillate VF at 830 V. The combination of a subcutaneous array and azygos vein coil successfully defibrillated VF. The mechanism for successful DFT reduction was likely greater current supplied to the posterior basal left ventricle by the azygos vein lead.
一名72岁的非缺血性心肌病男性患者前来就诊，原因是其植入式心律转复除颤器未能终止自发性室颤（VF）。除颤阈值（DFT）测试证实，尽管对双相波形进行了优化并反转了电击极性，但830V的电击仍未能使室颤除颤。植入新的右心室导线并增加皮下阵列后，在830V时仍未能使室颤除颤。皮下阵列和奇静脉线圈联合使用成功使室颤除颤。DFT降低成功的机制可能是奇静脉导线向左心室后基底提供了更大的电流。
