Ohashi Yuko, Ohkura Kazuhiro, Yamada Ayano
Department of Cardiac Surgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
Kyobu Geka. 2017 Nov;70(12):1017-1020.
A 71-year-old woman was diagnosed with sick sinus syndrome (SSS) upon her cardiogenic cerebral embolism and underwent pacemaker implantation. Active fixation leads were positioned at the right atrial appendage and ventricular septum. Twenty-one days later at her routine checkup, she was asymptomatic and there were no signs of cardiac tamponade or pacing failure. But echocardiography and computed tomography revealed a large amount of pericardial effusion due to the lead perforation. We performed open drainage because her anticoagulant could not be stopped for her history of cerebral infarction. Upon surgery, 400 ml of hemorrhagic pericardial effusion was drained and we found a lead tip penetrating through the right atrial appendage. We should carefully observe for lead perforation after pacemaker implantation, especially when using the active fixation lead.
一名71岁女性在发生心源性脑栓塞后被诊断为病态窦房结综合征（SSS），并接受了起搏器植入术。主动固定电极被置于右心耳和室间隔。21天后在她的常规检查中，她没有症状，也没有心脏压塞或起搏失败的迹象。但超声心动图和计算机断层扫描显示由于电极穿孔导致大量心包积液。由于她有脑梗死病史不能停用抗凝药，我们进行了开放引流。手术中，引出了400毫升血性心包积液，我们发现电极尖端穿透了右心耳。起搏器植入后我们应仔细观察电极穿孔情况，尤其是在使用主动固定电极时。
