Department of Medicine, Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA.
Department of Medicine, Division of Cardiology, Section of Cardiac Electrophysiology, Henry Ford Hospital, Detroit, Michigan, USA.
Pacing Clin Electrophysiol. 2021 Apr;44(4):751-754. doi: 10.1111/pace.14190. Epub 2021 Feb 19.
An elderly gentleman with a dual-chamber pacemaker presented to our institution with symptoms of symptomatic bradycardia and high-grade atrioventricular (AV) block. Device interrogation revealed failure to capture in the right ventricle (RV) lead with bipolar pacing, high RV pacing threshold with unipolar pacing, and high impedance suggesting lead fracture. The atrial lead function was normal. Given his advanced age, gait instability, and dementia, the decision was made to proceed with Micra AV pacemaker implantation, while programming his dual-chamber pacemaker to AAIR mode, thus maintaining AV synchrony by tracking paced atrial impulses and providing ventricular pacing.
一位老年绅士装有双腔起搏器，因症状性心动过缓及高度房室（AV）阻滞到我院就诊。设备检测显示右心室（RV）导联双极起搏失夺获，单极起搏 RV 起搏阈值高，且提示导联断裂的高阻抗。心房导联功能正常。鉴于他年龄较大、步态不稳和痴呆，决定进行 Micra AV 起搏器植入，同时程控他的双腔起搏器为 AAIR 模式，通过跟踪起搏的心房脉冲提供心室起搏，从而保持 AV 同步。
