埋藏式心脏复律除颤器与单极导线起搏器的合并应用一例报告

Combined use of implantable cardioverterdefibfillator with unipolar pacemaker

国内首次合并应用埋藏式心脏复律除颤器（ＩＣＤ）与单极起搏器１例。术中仔细观察起搏器对ＩＣＤ的影响，未发现ＩＣＤ对起搏心律的双感知，亦未发现对心室颤动（室颤）的感知不足，ＩＣＤ对３次诱发的室颤均迅速感知并一次除颤成功。术后１８９天储存资料显示患者共自发２１次室性心动过速，均被一次抗心动过速起搏有效终止，未发生误放电，亦未漏诊快速心律失常，初步观察效果满意。

This is the first case combining use of implantable cardioverterdefibrillator (ICD) with unipolar pacemaker in our country. The effect of pacemaker on ICD was carefully evaluated during implantation. There were no double sensing of ICD to pacing rhythm and no undersensing to ventricular fibrillation (VF). ICD rapidly detected the induced VFs in three tests and successfully defibrillated the Vf by one shock in every test. The stored data of 189 days postimplantation showed that total twenty one episodes of spontaneous ventricular tachycardias were detected and every episode was successfully terminated by only one burst of antitachycardiac pacing. There was no faulty delivery of therapy and no loss of detecting tachyarrhythmias. The result of combined ICD with unipolar pacemaker was satisfying in the preliminary observation.