Schuchert A, Hoffmann M, Steffgen F, Meinertz T
Department of Cardiology, University-Hospital Eppendorf, Germany.
Pacing Clin Electrophysiol. 1998 Feb;21(2):471-3. doi: 10.1111/j.1540-8159.1998.tb00076.x.
During implantable cardioverter defibrillator (ICD) implantation of an active can ICD several defibrillations with 20 J and 34 J as well as 360 J externally were ineffective. The implant criteria were finally met with a second defibrillation lead and reversed polarity. A left-sided pneumothorax due to subclavian vein puncture was detected soon after ICD implantation. It is assumed that especially in the active can alignment the developing pneumothorax made defibrillation current flow more difficult. In case of several unsuccessful defibrillations during active can ICD implantation in which the subclavian vein was punctured, the possibility of a pneumothorax should be considered.
在植入有源除颤罐式植入式心脏复律除颤器（ICD）过程中，使用20 J和34 J进行多次体内除颤以及360 J体外除颤均无效。最终通过植入第二根除颤导线并反转极性满足了植入标准。ICD植入后不久检测到因锁骨下静脉穿刺导致的左侧气胸。据推测，特别是在有源除颤罐的布局中，正在形成的气胸使除颤电流更难通过。在有源除颤罐式ICD植入过程中锁骨下静脉被穿刺且多次除颤失败的情况下，应考虑气胸的可能性。
