Lawrie G M, Kaushik R R, Pacifico A
Cora and Webb Mading Department of Surgery and Medicine (Cardiology), Baylor College of Medicine, Houston, Texas 77030.
Ann Thorac Surg. 1989 May;47(5):780-1. doi: 10.1016/0003-4975(89)90147-1.
High defibrillation thresholds are encountered in some patients during implantation of the automatic implantable cardioverter defibrillator (AICD). In a consecutive series of 52 patients with AICD implants, 46 had allepicardial implants by left subcostal thoracotomy, and 8 of these patients had thresholds greater than 30 J. Placement of an apicolateral large left ventricular patch and an extrapericardial large right atrial patch electrode through a limited right thoracotomy produced substantial reduction in their thresholds. Especially in patients who have had previous intrapericardial operations, this technique provides a simple solution to the problem of high thresholds.
在植入自动植入式心脏复律除颤器（AICD）时，一些患者会出现高除颤阈值。在连续的52例接受AICD植入的患者系列中，46例通过左肋下胸廓切开术进行心外膜植入，其中8例患者的阈值大于30焦耳。通过有限的右胸廓切开术放置心尖外侧大左心室补片和心外膜大右心房补片电极，可使其阈值大幅降低。特别是对于既往有心包内手术史的患者，该技术为高阈值问题提供了一个简单的解决方案。
