全皮下植入型心律转复除颤器不恰当放电的原因和机制

Causes and mechanisms of inappropriate shocks in entirely subcutaneous implantable cardioverter defibrillators

过度感知心内信号(T波、P波、F波、f波或U波)、QRS波群多重计数、室上性心动过速频率过快、肌电干扰、空气滞留、电极导线与脉冲发生器故障、心肺复苏、体外电磁干扰、Sense-B噪声等多种原因,都可能导致探测到的频率到达除颤区,发生全皮下植入型心律转复除颤器的不恰当放电。发生不恰当放电后,建议程控重新调整参数,积极治疗基础疾病,必要时需要调整电极导线和脉冲发生器,或是植入经静脉植入型心律转复除颤器。

Various reasons may lead to inappropriate shocks of entirely subcutaneous implantable cardioverter defibrillator as the detected frequencies reach the shock zone.These reasons include the oversensing of intracardiac signals(such as T,P,F,f,or U waves),multiple counting of QRS complexes,rapid supraventricular tachycardia,myopotential interference,air entrapment,failure of electrode lead or pulse generator,cardiopulmonary resuscitation,in vitro electromagnetic interference,and Sense-B-noise.It is recommended to readjust its parameters by programmable controlling,and actively treat primary diseases.It is required to adjust the electrode lead and pulse generator,or implant a transvenous implantable cardioverter defibrillator instead if necessary.