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起搏器导线不完全断裂,因分钟通气传感器脉冲感知过度导致不适当的起搏抑制。

An incomplete pacemaker lead fracture causing inappropriate pacing inhibition due to oversensing of the minute ventilation sensor pulses.

作者信息

Sugiura Shinya, Matsuoka Koji, Ikami Akiyoshi, Shioji Hirokazu, Takasaki Akihiro, Koji Takafumi, Tanigawa Takashi, Ito Masaaki

机构信息

Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan.

Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.

出版信息

J Cardiol Cases. 2018 May 7;18(2):47-51. doi: 10.1016/j.jccase.2018.04.005. eCollection 2018 Aug.

Abstract

Cardiac pacemakers using rate response technologies represent the effectiveness of increasing the heart rate and cardiac output during exercise. Minute ventilation (MV) sensors are popular and estimate rates using transthoracic impedance by emitting very low amperage short electrical current pulses between the pacemaker lead tip and pulse generator. We present a case of an incomplete pacemaker lead fracture developing inappropriate pacing inhibition due to oversensing caused by the electrical current emitted by the MV sensor. A permanent pacemaker replacement was performed, resulting in no further abnormal findings such as inappropriate pacing inhibition. < The minute ventilation (MV) sensor is estimated using the transthoracic impedance by emitting a very low amperage and short pulses of electrical current between the pacemaker lead tip and pulse generator. Therefore, if a fractured lead occurs, the voltage from the current pulses emitted for the MV sensor might be high enough to be oversensed as ventricular waves. We recommend that it is necessary to keep in mind the possibility of a fractured lead if oversensing of the thoracic impedance measurement current is observed.>.

摘要

使用速率响应技术的心脏起搏器体现了在运动期间提高心率和心输出量的有效性。分钟通气量(MV)传感器很常用,它通过在起搏器导线尖端和脉冲发生器之间发射极低安培数的短电流脉冲,利用经胸阻抗来估计速率。我们报告一例因MV传感器发出的电流导致感知过度而发生不完全起搏器导线断裂并出现不适当起搏抑制的病例。进行了永久性起搏器更换,此后未再出现诸如不适当起搏抑制等异常情况。<分钟通气量(MV)传感器通过在起搏器导线尖端和脉冲发生器之间发射极低安培数的短电流脉冲利用经胸阻抗来估计。因此,如果导线发生断裂,为MV传感器发射的电流脉冲产生的电压可能会高到足以被过度感知为心室波。我们建议,如果观察到胸阻抗测量电流的感知过度,有必要牢记导线断裂的可能性。>

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