摘要
目的探讨先后置入不同心脏装置的手术处理及注意事项。方法例1置入埋藏式心律转复除颤器(ICD)1年,射血分数(EF)0.30,心功能Ⅳ级,无经济能力再接受心脏再同步化联合除颤治疗(CRTD),决定保留原ICD情况下行心脏再同步化治疗(CRT);例2为Ⅲ度房室传导阻滞(AVB)置入VVI 3年后反复发生心室颤动,EF0.35,但无经济能力接受CRTD,保留起搏器情况下置入ICD;例3为扩张型心肌病,因高度AVB置入DDD起搏器后3年,反复室性心动过速入院,决定将原来的DDD起搏器更换为CRTD。结果均顺利分别置入CRT、ICD和CRTD,例1、例2术中测试均未发现装置间的相互影响。结论先后在同一患者置入不同心脏装置的手术是可行的,但术中应明确排除起搏和除颤电极之间可能存在的相互干扰。
Objective To study the feasibility and key items for management of implanting different heart apparatus successively. Methods Case 1 was implanted implantable cardioverter defibrillator （ICD） for 1 year with eject fraction （EF） 0.30 and NYHA class IV. Prior ICD was remained and cardiac resynchronization therapy （CRT） was performed since he couldn＇t afford the expense of CRTD （ CRT ＋ ICD）. Case 2 who was embedded VVI pacemaker due to m atrio- ventricular block （AVB） 3 years ago had undergone recurrent ventricular fibrillation. Though the best choice for him was CRTD as the EF was 0.35, implanting the ICD was the final decision since the economic reason. Case 3 was diagnosed di- lated cardiomyopathy and implanted DDD pacemaker due to advanced AVB 3 years ago. He was hospitalized by recurrent persistent ventricular tachycardia and decided to accept CRTD. Results 3 cases were successful implanted CRT, ICD and CRTD respectively. There were no interference between apparatus in case 1 and case 2. Conclusions It is feasible to implant different heart apparatus successively in one patient. The interference of electrode between ICD and pacemaker should be eliminated during the operation. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2008,22 （5） ：407 - 410]
出处
《中国心脏起搏与心电生理杂志》
2008年第5期407-410,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
