皮下植入式心律转复除颤器中“不适当的适当”电击：SMART pass算法的重要性。
An "inappropriately appropriate" shock in a subcutaneous implantable cardioverter-defibrillator: The importance of the SMART pass algorithm.
作者信息
Rubio Campal José M, Benezet-Mazuecos Juan, Sánchez-Borque Pepa, Blanco Ángel Miracle, Crosa Julián, Arias Miguel Angel
机构信息
Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain.
Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain.
出版信息
J Electrocardiol. 2018 Nov-Dec;51(6):941-944. doi: 10.1016/j.jelectrocard.2018.07.021. Epub 2018 Jul 26.
We report on a case of a 78-years-old patient with a subcutaneous implantable cardioverter defibrillator (S-ICD) and an episode of a sustained ventricular tachycardia (VT) at a rate slower than the programmed shock zone. Because of T-wave oversensing the device interpreted it as fast VT that triggered the delivery of an "inappropriately appropriate shock" that terminated it. The patient had again more VT episodes but after programming the SMART pass algorithm (previously programmed "OFF") the device showed no longer frequent T-wave oversensing and no additional inappropriate shocks occurred.
我们报告了一例78岁的患者，其植入了皮下植入式心律转复除颤器（S-ICD），并发生了一次持续性室性心动过速（VT），其速率低于程控的电击治疗区。由于T波感知过度，该装置将其解读为快速VT，从而触发了一次“不恰当但合适的电击”，终止了心动过速。该患者又出现了更多次VT发作，但在对SMART pass算法进行编程（之前设置为“关闭”）后，该装置不再频繁出现T波感知过度，也未再发生额外的不恰当电击。
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