植入永久性起搏器时除颤的并发症。

Complications of defibrillation with permanent pacemaker in situ.

作者信息

Aylward P, Blood R, Tonkin A

出版信息

Pacing Clin Electrophysiol. 1979 Jul;2(4):462-4. doi: 10.1111/j.1540-8159.1979.tb05222.x.

DOI:10.1111/j.1540-8159.1979.tb05222.x

Abstract

A permanent demand pacing generator was implanted in the right deltopectoral fossa with unipolar transvenous lead advanced to the right ventricle. Implant and subsequent pacing parameters were normal. Five days later an emergency DC cardioversion was performed with one paddle 2 inches from the generator. Cardioversion was followed by failure of QRS-sensing and, at immediate explant, rise in stimulation threshold. The pulse generator showed end-of-life characteristics. The patient died 4 days following replacement of the generator and lead. At autopsy, right ventricular infarction was found, presumably relating to current discharge along the lead. Pacemaker analysis showed damage to the protection zener diode and oscillator integrated circuit of the generator during cardioversion.

摘要

将一个永久性按需起搏发生器植入右三角肌胸大肌沟内，单极经静脉导线推进至右心室。植入及随后的起搏参数正常。五天后，使用一个电极板距离发生器2英寸进行紧急直流电复律。复律后出现QRS波感知失败，立即进行取出时，刺激阈值升高。脉冲发生器显示出寿命终止的特征。在更换发生器和导线4天后患者死亡。尸检发现右心室梗死，推测与沿导线的电流放电有关。起搏器分析显示在复律期间发生器的保护齐纳二极管和振荡器集成电路受损。