Goto Kentaro, Miyazaki Shinsuke, Oyaizu Takuya, Negishi Miho, Ikenouchi Takashi, Yamamoto Tasuku, Kawamura Iwanari, Nishimura Takuro, Takamiya Tomomasa, Tao Susumu, Takigawa Masateru, Yagishita Kazuyoshi, Sasano Tetsuo
Department of Cardiovascular Medicine Tokyo Medical and Dental University Hospital Tokyo Japan.
Department of Hyperbaric Medical Center Tokyo Medical and Dental University Hospital Tokyo Japan.
J Arrhythm. 2024 May 20;40(4):958-964. doi: 10.1002/joa3.13070. eCollection 2024 Aug.
The safety of hyperbaric oxygen treatment (HBO) in patients with cardiovascular implanted electronic devices (CIED) remains unclear.
We conducted a retrospective analysis of seven CIED patients (median age 79 [73-83] years, five males [71.4%]), including five with pacemakers and two with implantable cardioverter defibrillators (ICD), who underwent HBO between June 2013 and April 2023. During the initial session, electrocardiogram monitoring was conducted, and CIED checks were performed before and after the treatment. In addition, the medical records were scrutinized to identify any abnormal CIED operations.
All seven CIED patients underwent HBO within the safety pressure range specified by the CIED manufacturers or general pressure test by the International Organization for Standardization (2.5 [2.5-2.5] atmosphere absolute × 18 [5-20] sessions). When comparing the CIED parameters before and after HBO, no significant changes were observed in the waveform amplitudes, pacing thresholds, lead impedance of the atrial and ventricular leads, or battery levels. All seven patients, including two with the rate response function activated, exhibited no significant changes in the pacing rate or pacing failure. Two ICD patients did not deactivate the therapy, including the defibrillation; however, they did not experience any arrhythmia or inappropriate ICD therapy during the HBO.
CIED patients who underwent HBO within the safety pressure range exhibited no significant changes in the parameters immediately after the HBO and had no observable abnormal CIED operations during the treatment. The safety of defibrillation by an ICD during HBO should be clarified.
心血管植入式电子设备（CIED）患者接受高压氧治疗（HBO）的安全性尚不清楚。
我们对2013年6月至2023年4月期间接受HBO治疗的7例CIED患者（中位年龄79[73 - 83]岁，5例男性[71.4%]）进行了回顾性分析，其中包括5例起搏器患者和2例植入式心律转复除颤器（ICD）患者。在初始治疗期间，进行心电图监测，并在治疗前后对CIED进行检查。此外，仔细审查病历以确定任何异常的CIED操作。
所有7例CIED患者均在CIED制造商规定的安全压力范围内或国际标准化组织的一般压力测试（2.5[2.5 - 2.5]绝对大气压×18[5 - 20]次治疗）下接受了HBO治疗。比较HBO治疗前后的CIED参数，心房和心室导联的波形幅度、起搏阈值、导联阻抗或电池电量均未观察到显著变化。所有7例患者，包括2例激活了频率应答功能的患者，起搏频率或起搏失败均无显著变化。2例ICD患者未停用治疗，包括除颤功能；然而，他们在HBO治疗期间未发生任何心律失常或不适当的ICD治疗。
在安全压力范围内接受HBO治疗的CIED患者在HBO治疗后即刻参数无显著变化，治疗期间未观察到异常的CIED操作。ICD在HBO治疗期间除颤的安全性有待阐明。
