Luria D, Stanton M S, Eldar M, Glikson M
Neufeld Cardiac Research Institute, Tel Aviv University, Israel.
Pacing Clin Electrophysiol. 1998 Feb;21(2):474-5. doi: 10.1111/j.1540-8159.1998.tb00077.x.
We describe two patients with defibrillation failure of implantable cardioverter defibrillators (ICDs) resulting from large left pneumothoraxes following subclavian vein puncture during the implantation. Following pneumothorax drainage, low defibrillation thresholds (DFTs) were attained without further manipulations. The absence of other signs and symptoms of pneumothorax and the presence of satisfactory pacing function during the procedure, resulted in a significant delay in diagnosis. Pneumothorax should be included in the differential diagnosis when unexpected high DFTs are found during ICD implantation or predischarge testing. This complication is avoidable by a different surgical approach, cephalic vein cutdown.
我们描述了两名植入式心脏转复除颤器（ICD）患者，他们在植入过程中锁骨下静脉穿刺后出现大量左侧气胸，导致除颤失败。气胸引流后，无需进一步操作即可达到低除颤阈值（DFT）。由于术中无其他气胸体征和症状，且起搏功能良好，导致诊断显著延迟。在ICD植入或出院前测试中发现意外的高DFT时，应将气胸纳入鉴别诊断。采用不同的手术方法，即头静脉切开术，可避免这种并发症。
