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具有正常起搏和感知参数的双腔起搏器中的心输出量抑制：机制是什么？

Inhibition of ventricular output in a dual chamber pacemaker with normal pacing and sensing parameters: What is the mechanism?

作者信息

Bera Debabrata, Joshi Radhey Shyam, Majumder Suchit, Mukherjee Sanjeev S

机构信息

Dept of Cardiology, RTIICS, Kolkata, India.

Dept of Cardiology, RTIICS, Kolkata, India.

出版信息

Indian Pacing Electrophysiol J. 2022 Jan-Feb;22(1):30-33. doi: 10.1016/j.ipej.2021.09.001. Epub 2021 Sep 4.

DOI:10.1016/j.ipej.2021.09.001
PMID:34492301
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8811278/
Abstract

A 65-year-old gentleman with dual chamber pacemaker presented with presyncope. The ECG raised concerns of oversensing which was confirmed by magnet response. The device interrogation revealed noise in ventricular channel temporally associated with P wave. The pacing thresholds were normal. Although the ventricular lead impedance was within normal limit the impedance trend suggested 100 Ω decline over last 1 year. RV lead insulation failure was speculated and supported by the bipolar and unipolar intracardiac electrogram. Device was programmed to DOO temporarily. He underwent RV lead replacement uneventfully.

摘要

一位植入双腔起搏器的65岁男性患者出现前驱晕厥。心电图引发了对感知过度的担忧，通过磁铁反应得以证实。设备问询显示心室通道存在与P波在时间上相关的噪声。起搏阈值正常。尽管心室导线阻抗在正常范围内，但阻抗趋势表明在过去1年中下降了100Ω。推测右心室导线绝缘故障，并得到双极和单极心内电图的支持。设备被临时程控为DOO模式。他顺利接受了右心室导线更换。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/4e145306eb0a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/63ec18dd4aa0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/ad55a29271d6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/4e145306eb0a/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/63ec18dd4aa0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/ad55a29271d6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153f/8811278/4e145306eb0a/gr3.jpg

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Far-field P-wave sensing by the right ventricular lead of conventional dual chamber pacemakers.传统双腔起搏器右心室电极进行远场P波感知。
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