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皮下植入式心律转复除颤器因血肿形成继发T波感知过度：植入后早期不适当电击的一个潜在原因。

T wave oversensing in subcutaneous implantable cardioverter defibrillator secondary to hematoma formation: A potential cause of early postimplantation inappropriate shocks.

作者信息

Halawa Ahmad, Gautam Sandeep

机构信息

Division of Cardiovascular Medicine University of Missouri-Columbia Columbia Missouri.

出版信息

J Arrhythm. 2018 Nov 21;35(1):130-132. doi: 10.1002/joa3.12132. eCollection 2019 Feb.

DOI:10.1002/joa3.12132
PMID:30805053
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6373653/
Abstract

T wave oversensing (TWOS) is the most common cause of inappropriate shocks in subcutaneous cardioverter-defibrillators (S-ICD). We are presenting a patient with severe ischemic cardiomyopathy who received a S-ICD while on antiplatelets therapy. Pressure dressing was applied due to significant bleeding. On the first postoperative day, the device delivered 26 inappropriate shocks after removal of the pressure dressing. Interrogation revealed new TWOS, likely related to changes in the sensing vectors after hematoma formation.

摘要

T波过度感知（TWOS）是皮下植入式心律转复除颤器（S-ICD）不适当电击的最常见原因。我们报告一例严重缺血性心肌病患者，在接受抗血小板治疗期间植入了S-ICD。由于大量出血，使用了加压包扎。术后第一天，去除加压包扎后，该装置发出了26次不适当电击。问询显示出现了新的T波过度感知，可能与血肿形成后感知向量的变化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af8/6373653/7f93e1c3d4f4/JOA3-35-130-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af8/6373653/9582956bd310/JOA3-35-130-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af8/6373653/7f93e1c3d4f4/JOA3-35-130-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af8/6373653/9582956bd310/JOA3-35-130-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2af8/6373653/7f93e1c3d4f4/JOA3-35-130-g002.jpg

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本文引用的文献

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Heart Rhythm. 2018 Oct;15(10):1515-1522. doi: 10.1016/j.hrthm.2018.05.011. Epub 2018 Jun 8.
2
Perioperative hematoma with subcutaneous ICD implantation: Impact of anticoagulation and antiplatelet therapies.皮下植入式心律转复除颤器围手术期血肿：抗凝和抗血小板治疗的影响
Pacing Clin Electrophysiol. 2018 Jul;41(7):799-806. doi: 10.1111/pace.13349. Epub 2018 May 22.
3
Implant and Midterm Outcomes of the Subcutaneous Implantable Cardioverter-Defibrillator Registry: The EFFORTLESS Study.
皮下植入式心脏复律除颤器注册研究的植入和中期结果：EFFORTLESS 研究。
J Am Coll Cardiol. 2017 Aug 15;70(7):830-841. doi: 10.1016/j.jacc.2017.06.040.
4
2015 European Society of Cardiology Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death summarized by co-chairs.2015 年欧洲心脏病学会关于心室性心律失常患者管理和心源性猝死预防指南概要，由共同主席总结。
Eur Heart J. 2015 Nov 1;36(41):2757-9. doi: 10.1093/eurheartj/ehv445.
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The subcutaneous defibrillator: a review of the literature.皮下除颤器：文献回顾。
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