Almassi G H, Chapman P D, Troup P J, Wetherbee J N, Olinger G N
Chest. 1987 Aug;92(2):369-71. doi: 10.1378/chest.92.2.369.
A case of constrictive pericarditis intimately involving patch electrodes of the automatic implantable cardioverter-defibrillator is described. Typical clinical and hemodynamic findings for constrictive pericarditis were noted 15 months after lead installation. Additionally, chest x-ray examination revealed a severe crumpling deformity of the patch electrodes. Thoracotomy was performed and revealed marked fibrous reaction surrounding both surfaces of each patch electrode. Histologic examination revealed fibrous tissue with multinucleated giant cells, consistent with a foreign body reaction. The patient had complete resolution of signs and symptoms of constrictive pericarditis after removal of the patch electrodes and pericardial stripping. Constrictive pericarditis from implanted patch electrodes appears to be an uncommon complication of the automatic implantable cardioverter-defibrillator and should be considered in patients with one or more patch electrodes and other signs of constrictive pericarditis.
本文描述了一例缩窄性心包炎与植入式自动心脏复律除颤器的片状电极紧密相关的病例。在电极植入15个月后出现了缩窄性心包炎的典型临床和血流动力学表现。此外，胸部X线检查显示片状电极严重皱缩变形。进行了开胸手术，发现每个片状电极的两面均有明显的纤维反应。组织学检查显示有含多核巨细胞的纤维组织，符合异物反应。在移除片状电极并进行心包剥脱术后，患者缩窄性心包炎的体征和症状完全消失。植入片状电极导致的缩窄性心包炎似乎是植入式自动心脏复律除颤器的一种罕见并发症，对于有一个或多个片状电极且有其他缩窄性心包炎体征的患者应予以考虑。
