Vassolas G, Roth R A, Venditti F J
Section of Cardiology, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
Pacing Clin Electrophysiol. 1993 Jun;16(6):1245-8. doi: 10.1111/j.1540-8159.1993.tb01710.x.
Extracorporeal shock wave lithotripsy (ESWL) is frequently used for nephrolithiasis of the upper urinary tract. Because of the powerful shock wave and electromechanical forces created, this therapy has been contraindicated in the patient with an implantable cardioverter defibrillator (ICD). To determine whether or not ESWL affects ICD devices, we subjected ten devices to a full course of ESWL. The devices were then returned to the manufacturer to undergo bench analysis, which revealed no abnormalities in function. Additionally, one device was placed in the pathway of the shock wave, resulting in a discharge of the device despite a frequency of ESWL of 100 shocks/min (well below the rate cutoff of that device). Manufacturer analysis of this device, likewise, revealed no abnormalities even though the device had been exposed to the focal point of the shock wave. We conclude that contralateral ESWL is not contraindicated for the patient with an ICD. We do, however, recommend a post-procedure evaluation to ensure appropriate function of the ICD.
体外冲击波碎石术（ESWL）常用于治疗上尿路肾结石。由于其产生的强大冲击波和机电力量，该疗法一直被植入式心脏复律除颤器（ICD）患者视为禁忌。为了确定ESWL是否会影响ICD设备，我们对十台设备进行了完整疗程的ESWL治疗。然后将这些设备返回制造商进行台架分析，结果显示功能无异常。此外，将一台设备置于冲击波路径中，尽管ESWL频率为每分钟100次冲击（远低于该设备的速率阈值），该设备仍发生了放电。同样，制造商对该设备的分析也显示没有异常，即使该设备已暴露于冲击波焦点处。我们得出结论，对于ICD患者，对侧ESWL并非禁忌。然而，我们确实建议术后进行评估，以确保ICD功能正常。
