Department of Cardiovascular internal medicine, National Cerebral and Cardiovascular Center, Japan.
Graduate School of Medical Sciences Kumamoto University, Japan.
Intern Med. 2021 Jun 15;60(12):1877-1880. doi: 10.2169/internalmedicine.6125-20. Epub 2021 Feb 1.
Extravascular cardiac resynchronization therapy (CRT) defibrillators (CRT-Ds) are ideal for recurrent blood stream infections. Furthermore, CRT is useful for patients intolerant to right ventricular (RV) pacing. The case was a 65-year-old man with a CRT-D who presented with a blood stream infection. Because he was hemodynamically unstable with temporary RV pacing, an epicardial CRT device was re-implanted concomitantly through a surgical procedure. After the operation, a subcutaneous implantable cardioverter defibrillator (S-ICD) was placed. However, not all pacing is eligible for S-ICD screening. Combination therapy with an epicardial CRT device and S-ICD might be an alternate option for cardiac surgery cases.
血管外心脏再同步治疗除颤器（CRT-D）是复发性血流感染的理想选择。此外，对于不能耐受右心室（RV）起搏的患者，CRT 也很有用。该病例为一名 65 岁男性，植入 CRT-D 后发生血流感染。由于他在 RV 临时起搏时血流动力学不稳定，因此通过手术同时重新植入心外膜 CRT 装置。手术后，放置了皮下植入式心律转复除颤器（S-ICD）。然而，并非所有起搏都符合 S-ICD 筛查标准。心外膜 CRT 装置和 S-ICD 的联合治疗可能是心脏手术病例的另一种选择。
