Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.
Evaluation of acute cardiac and chest wall damage after shocks with a subcutaneous implantable cardioverter defibrillator in Swine.
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DOI：
10.1111/pace.12173
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发表时间：
2013-10
期刊：
影响因子：
--
通讯作者：
Walcott GP
中科院分区：
文献类型：
--
作者：
Killingsworth CR;Melnick SB;Litovsky SH;Ideker RE;Walcott GP
皮下埋藏式心脏复律除颤器(S-ICD)可以简化经静脉ICD的放置，减少并发症，但需要比经静脉ICD更多的能量。因此，我们评估了两种临床设备提供的最大能量电击所造成的心脏和胸壁损伤。在窦性心律时，麻醉猪(38±6 kg)接受S-ICD(n=4)和80焦耳(J)电击5次，或经静脉ICD(n=4)和35-J电击(35-J)。将无活性的S-ICD电极植入同一对照猪体内，以研究种植创伤。所有动物均存活24小时。测定肌钙蛋白I和肌酸激酶同工酶(CK-MM)作为心肌和骨骼肌损伤的指标。心脏、肺和胸壁的组织病理学损伤用半定量评分进行评估。对照猪肌钙蛋白I在4小时和24小时显著升高(22.6±16.3和3.1±1.3 ng/ml；基线0.07±0.09 ng/ml)，而S病猪无明显升高(0.12±0.11和0.13±0.13 ng/ml；基线0.06±0.03 ng/ml)。S-ICD猪休克后CK-MM显著升高(6544±1496和9705±6240U/L；基线704±398U/L)，而对照组无明显升高。对照组在休克后出现心电图改变，而S病猪则无此改变。两组心肌和肺组织学检查均正常。与对照组相比，S颈内动脉硬化症患者的皮下损伤更严重。虽然CK-MM提示S-ICD猪骨骼肌损伤较多，但两组均未检测到明显的心、肺和胸壁组织病理学变化。肌钙蛋白I数据显示，80-J S-ICD电击对心脏的损伤显著低于35-J经静脉电击。
A subcutaneous implantable cardioverter defibrillator (S-ICD) could ease placement and reduce complications of transvenous ICDs, but requires more energy than transvenous ICDs. Therefore we assessed cardiac and chest wall damage caused by the maximum energy shocks delivered by both types of clinical devices. During sinus rhythm, anesthetized pigs (38±6 kg) received an S-ICD (n = 4) and five 80-Joule (J) shocks, or a transvenous ICD (control, n = 4) and five 35-J shocks. An inactive S-ICD electrode was implanted into the same control pigs to study implant trauma. All animals survived 24-hours. Troponin I and creatine kinase muscle isoenzyme (CK-MM) were measured as indicators of myocardial and skeletal muscle injury. Histopathological injury of heart, lungs, and chest wall was assessed using semi-quantitative scoring. Troponin I was significantly elevated at 4- and 24-hours (22.6±16.3 and 3.1±1.3 ng/ml; baseline 0.07±0.09 ng/ml) in control pigs but not in S-ICD pigs (0.12±0.11 and 0.13±0.13 ng/ml; baseline 0.06±0.03 ng/ml). CK-MM was significantly elevated in S-ICD pigs after shocks (6544±1496 and 9705±6240 U/L; baseline 704±398 U/L) but not in controls. ECG changes occurred post-shock in controls but not in S-ICD pigs. The myocardium and lungs were histologically normal in both groups. Subcutaneous injury was greater in S-ICD compared to controls. Although CK-MM suggested more skeletal muscle injury in S-ICD pigs, significant cardiac, lung, and chest wall histopathological changes were not detected in either group. Troponin I data indicate significantly less cardiac injury from 80-J S-ICD shocks than 35-J transvenous shocks.
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影响因子：
2.8
作者：
Joglar, JA;Kessler, DJ;Page, RL
通讯作者：
Page, RL
影响因子：
37.8
作者：
Huang J;Walcott GP;Ruse RB;Bohanan SJ;Killingsworth CR;Ideker RE
通讯作者：
Ideker RE
影响因子：
39.3
作者：
Brunn, J;Böcker, D;Block, M
通讯作者：
Block, M
DOI：
10.1016/s0735-1097(87)80058-x
发表时间：
1987-03-01
影响因子：
24
作者：
FAIN, ES;BILLINGHAM, M;WINKLE, RA
通讯作者：
WINKLE, RA
影响因子：
6.5
作者：
Grubb, NR;Fox, KAA;Cawood, P
通讯作者：
Cawood, P