Khurwolah Mohammad Reeaze, Vezi Brian Zwelethini
Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa. Email:
Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa.
Cardiovasc J Afr. 2017 Mar/Apr;28(2):134-136. doi: 10.5830/CVJA-2016-081.
In the daily practice of pacemaker insertion, the occurrence of atrial and ventricular lead switch at the pacemaker box header is a rare and unintentional phenomenon, with less than five cases reported in the literature. The lead switch may have dire consequences, depending on the indication for the pacemaker. One of these consequences is pacemaker syndrome, in which the normal sequence of atrial and ventricular activation is impaired, leading to sub-optimal ventricular filling and cardiac output. It is important for the attending physician to recognise any worsening of symptoms in a patient who has recently had a permanent pacemaker inserted. In the case of a dual-chamber pacemaker, switching of the atrial and ventricular leads at the pacemaker box header should be strongly suspected. We present an unusual case of pacemaker syndrome and right ventricular-only pacinginduced left ventricular systolic dysfunction in a patient with a dual-chamber pacemaker.
在起搏器植入的日常操作中，起搏器盒式接头处心房和心室导线发生切换是一种罕见的意外现象，文献报道不足5例。导线切换可能会产生严重后果，具体取决于起搏器的适应证。其中一个后果是起搏器综合征，即心房和心室激活的正常顺序受损，导致心室充盈和心输出量不理想。对于近期植入永久性起搏器的患者，主治医生认识到其症状的任何恶化情况非常重要。对于双腔起搏器，应高度怀疑在起搏器盒式接头处发生了心房和心室导线的切换。我们报告了一例双腔起搏器患者发生起搏器综合征及右心室单腔起搏诱发左心室收缩功能障碍的罕见病例。
