Takasugi J E, Godwin J D, Bardy G H
Department of Radiology, Veterans Administration Medical Center, Seattle, WA 98108.
Radiographics. 1994 Nov;14(6):1275-90. doi: 10.1148/radiographics.14.6.7855341.
Safer and easier placement, recent approval by the U.S. Food and Drug Administration of several models, and increasing availability have expanded the use of implantable cardioverter-defibrillators (ICDs) for treatment of life-threatening ventricular tachyarrhythmia. Modern ICDs generally use a combination of two transvenously placed electrodes and one subcutaneous electrode; therefore, they do not require a thoracotomy for placement. The authors evaluated the radiographic aspects of one particular ICD--the pacemaker-cardioverter-defibrillator (PCD)--including the normal appearance and variations, confusing findings, and such complications as deformity of the subcutaneous patch electrode, lead fracture, and electrode malposition and migration. The PCD can also be combined with a preexisting, surgically placed automatic ICD or with a pacemaker. Familiarity with the PCD and other ICDs is essential, since the radiologist may be the first to recognize a complication that can render the device inoperative and leave the patient vulnerable to sudden death.
更安全、更简便的植入方式，美国食品药品监督管理局近期对几种型号的批准，以及日益增加的可及性，使得植入式心脏复律除颤器（ICD）用于治疗危及生命的室性快速心律失常的应用得到了扩展。现代ICD通常使用两根经静脉放置的电极和一根皮下电极的组合；因此，它们不需要开胸进行植入。作者评估了一种特定的ICD——起搏器-心脏复律除颤器（PCD）的影像学表现，包括正常外观及变异、易混淆的表现，以及诸如皮下贴片电极畸形、导线断裂、电极位置不当和移位等并发症。PCD还可以与预先存在的、通过手术植入的自动ICD或起搏器相结合。熟悉PCD和其他ICD至关重要，因为放射科医生可能是最先识别出会使设备无法工作并使患者易发生猝死的并发症的人。
