Trappe H J, Pfitzner P, Heintze J, Kielblock B, Wenzlaff P, Fieguth H G, Demertzis S, Lichtlen P R, Panning B, Piepenbrock S
Department of Cardiology, University Hospital, Hannover, Germany.
Am Heart J. 1995 Feb;129(2):259-64. doi: 10.1016/0002-8703(95)90006-3.
The exponential increase in cardioverter-defibrillator implantations has resulted in a need for safe implantations that do not require long waiting periods. We report intraoperative and follow-up results in 48 patients with ventricular tachyarrhythmias who underwent cardioverter-defibrillator implantation in the catheterization laboratory. Twenty-six (54%) patients had their first cardioverter-defibrillator implant (group 1), and 22 (46%) patients underwent pulse-generator replacement (group 2). In all patients, cardioverter-defibrillator implant or pulse-generator replacement was performed with the patient under general anesthesia. In 25 (96%) of 26 patients in group 1, cardioverter-defibrillator implantation was possible with a mean defibrillation threshold of 13 +/- 8 J. One patient had a defibrillation threshold of > 25 J, and therefore cardioverter-defibrillator implant was not achieved. This patient underwent epicardial device implantation 1 day later. Another patient in group 1 had vessel rupture (vena subclavia) intraoperatively. During a mean follow-up of 2 +/- 1 months, two patients died from congestive heart failure 2 and 4 months after device implantation. An infection occurred in one patient in group 2, 3 months after generator replacement. In conclusion, these data show that in the majority of patients cardioverter-defibrillator implantation in the catheterization laboratory is safe and has a low complication rate and therefore can generally be recommended.
心脏复律除颤器植入数量呈指数级增长，因此需要安全的植入方式，且无需漫长的等待期。我们报告了48例室性快速性心律失常患者在导管室接受心脏复律除颤器植入的术中及随访结果。26例（54%）患者首次植入心脏复律除颤器（第1组），22例（46%）患者接受脉冲发生器更换（第2组）。所有患者均在全身麻醉下进行心脏复律除颤器植入或脉冲发生器更换。第1组26例患者中的25例（96%）成功植入心脏复律除颤器，平均除颤阈值为13±8焦耳。1例患者除颤阈值>25焦耳，因此未成功植入心脏复律除颤器。该患者于1天后接受心外膜装置植入。第1组的另1例患者术中发生血管破裂（锁骨下静脉）。在平均2±1个月的随访期间，2例患者在装置植入后2个月和4个月死于充血性心力衰竭。第2组1例患者在发生器更换后3个月发生感染。总之，这些数据表明，在大多数患者中，在导管室植入心脏复律除颤器是安全的，并发症发生率低，因此通常可以推荐。
