The pacemaker‐twiddler's syndrome: Another disadvantage of abdominal implantation of pulse generators
The pacemaker‐twiddler's syndrome: Another disadvantage of abdominal implantation of pulse generators
复制标题
起搏器旋转综合征：腹部植入脉冲发生器的另一个缺点
DOI：
10.1002/bjs.1800640915
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发表时间：
1977
影响因子：
9.6
通讯作者：
A. Basu
中科院分区：
文献类型：
--
作者：
B. N. Guharay;J. Ghose;H. Majumdar;A. Basu
在心外膜-壁内起搏器电极导线植入后，62名幸存者中有4名发生了由于起搏器旋转综合征（PTS）导致的起搏器电极导线断裂，每例患者的脉冲发生器均放置在左上象限肋下皮下囊袋中。腹部脉冲发生器口袋似乎邀请自发发生的PTS，更是在孕妇。PTS发展的重要诱发因素是包含液体池的过于宽敞的脉冲发生器囊袋。对心脏起搏技术进行一些简单的修改可以预防并发症;这些修改包括将脉冲发生器植入到胸肌更深的平面中，将脉冲发生器悬挂在锁骨上，并在伤口愈合的初始阶段对发生器囊袋进行真空抽吸引流。在存在最佳匹配的脉冲发生器囊袋的情况下，在没有患者积极参与的情况下，锁骨下胸大肌下脉冲发生器植入的PTS应该是罕见的。该综合征可能不是起搏器电极导线故障的罕见原因，因为文献中的报告相对较少。
Breakage of a pacer lead due to the pacemaker‐twiddler's syndrome (PTS) occurred in 4 of 62 survivors following epicardial–intramural pacer lead implantation with the pulse generator placed in each case in a subcostal left upper quadrant subcutaneous pocket. The abdominal pulse generator pocket appears to invite spontaneously occurring PTS, more so in a pregnant woman. The important predisposing factor to the development of PTS is an excessively spacious pulse generator pocket containing a pool of fluid. Addition of a few simple modifications to the technique of cardiac pacing would prevent the complication; these include implantation of the pulse generator in a plane deeper to the pectoral muscles, suspending the pulse generator from the clavicle and application of vacuum‐suction drainage to the generator pocket in the initial phase of wound healing. In the presence of an optimally fitting pulse generator pocket, PTS should be rare with subclavicular subpectoral pulse generator implantation without active patient participation. The syndrome may not be as rare a cause of pacer lead malfunction as may appear from the relative paucity of reports in the literature.