Kissoon Narayan R, Hoelzer Bryan C, Martin David P, Lamer Tim J
Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Pain Pract. 2017 Apr;17(4):558-563. doi: 10.1111/papr.12530. Epub 2016 Dec 30.
New advances in spinal cord stimulation have led to improved treatment of patients suffering from chronic pain. While the overall safety of newer stimulation devices has been established, no published reports exist regarding safety considerations when these devices are implanted in patients with a preexisting cardiac device.
An 83-year-old man with a history of out-of-hospital cardiac arrest secondary to an episode of ventricular fibrillation underwent automated implantable cardiac defibrillator placement. Concomitantly, he suffered from intractable chronic low axial back pain and was deemed a candidate for high-frequency (10 kHz) spinal cord stimulation (SCS). Cardiac monitoring during SCS trial and implantation was performed with no interference noted. Following high-frequency SCS implantation, the patient was observed to have significant pain relief with functional improvement.
While others have reported safety during traditional SCS in patients with implanted cardiac devices, this is the first case report to describe safe and effective use of high-frequency SCS in a patient with an implanted cardiac device.
脊髓刺激技术的新进展已使慢性疼痛患者的治疗得到改善。虽然新型刺激设备的总体安全性已得到确立，但尚无关于将这些设备植入已有心脏设备的患者时的安全考量的公开报告。
一名83岁男性，有因室颤发作导致院外心脏骤停的病史，接受了自动植入式心脏除颤器植入术。同时，他患有顽固性慢性下腰部轴向疼痛，被认为是高频（10kHz）脊髓刺激（SCS）的候选者。在SCS试验和植入过程中进行了心脏监测，未发现干扰。高频SCS植入后，观察到患者疼痛明显缓解，功能得到改善。
虽然其他人报告了植入心脏设备的患者在传统SCS期间的安全性，但这是第一例描述在植入心脏设备的患者中安全有效地使用高频SCS的病例报告。
