Makaryus John N, Angert-Gilman Julia, Yacoub Mena, Patel Apoor, Goldner Bruce
Department of Cardiology, Division of Electrophysiology, North Shore-Long Island Jewish Health System, New Hyde Park, New York 11040.
Tex Heart Inst J. 2014 Feb;41(1):61-3. doi: 10.14503/THIJ-12-3005.
Implantable cardioverter-defibrillators (ICDs) are the standard of care for preventing sudden cardiac death in patients who are predisposed to malignant ventricular arrhythmias. Causes of inappropriate ICD shock include equipment malfunction, improper arrhythmia evaluation, misinterpretation of myopotentials, and electromagnetic interference. As the number of implanted ICDs has increased, other contributors to inappropriate therapy have become known, such as minimal electrical current leaks that mimic ventricular fibrillation. We present the case of a 63-year-old man with a biventricular ICD who received 2 inappropriate shocks, probably attributable to alternating-current leaks in a swimming pool. In addition, we discuss ICD sensitivity and offer recommendations to avoid similar occurrences.
植入式心脏复律除颤器(ICD)是预防易发生恶性室性心律失常患者心源性猝死的标准治疗手段。不恰当ICD电击的原因包括设备故障、心律失常评估不当、肌电位误判以及电磁干扰。随着植入ICD数量的增加,其他导致不恰当治疗的因素也逐渐为人所知,比如模拟室颤的微小电流泄漏。我们报告了一例63岁植入双心室ICD的男性患者,其接受了2次不恰当电击,可能归因于游泳池中的交流电泄漏。此外,我们讨论了ICD的敏感性并提供了避免类似情况发生的建议。