克服锁骨下静脉完全闭塞：通过锁骨下静脉进行简单的单根导线拔除，从而能够植入两根新导线并升级为具有多部位起搏功能的心脏再同步化治疗起搏器（CRT-P）。
Overcoming a subclavian complete occlusion: Simple single lead extraction by the subclavian vein allowing implantation of two new leads and upgrade to CRT-P with multi-site pacing.
作者信息
Nobre Menezes Miguel, Bernardes Ana, de Sousa João, Marques Pedro
机构信息
Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.
出版信息
Indian Pacing Electrophysiol J. 2015 Jul 29;15(2):118-20. doi: 10.1016/j.ipej.2015.07.008. eCollection 2015 Mar-Apr.
Abstract
Central venous obstruction following pacemaker implantation is not uncommon, and can prove challenging in the case of system upgrade. We report a case of DDDR to CRT-P (with multi-site pacing) upgrade, where a subclavian occlusion was overcome resorting to an atrial lead extraction (using only a locking stylet). This allowed regaining of the venous access with subsequent implantation of not just one, but two new leads and subsequent successful upgrade.
摘要
起搏器植入后发生中心静脉阻塞并不罕见，在系统升级的情况下可能会带来挑战。我们报告一例从DDDR升级为CRT-P（多部位起搏）的病例，其中通过心房导线拔除术（仅使用锁定管芯）克服了锁骨下静脉阻塞。这使得能够重新获得静脉通路，随后不仅植入了一根，而且植入了两根新导线，并最终成功完成升级。
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