Limitations and late complications of third-generation automatic cardioverter-defibrillators.
Limitations and late complications of third-generation automatic cardioverter-defibrillators.
复制标题
第三代自动心脏复律除颤器的局限性和晚期并发症。
DOI：
10.1161/01.cir.91.8.2204
复制
发表时间：
1995
期刊：
影响因子：
37.8
通讯作者：
J. Ruskin
中科院分区：
文献类型：
--
作者：
S. O. Nunain;M. Roelke;T. Trouton;S. Osswald;Y. H. Kim;G. Sosa;D. Brooks;B. Mcgovern;M. Guy;D. Torchiana;G. Vlahakes;H. Garan;J. Ruskin
背景
BACKGROUND
This study examines the limitations and complex management problems associated with the use of tiered-therapy, implantable cardioverter-defibrillators (ICDs).
METHODS AND RESULTS
The study group comprises the first 154 patients undergoing implantation of tiered-therapy ICDs at our institution. Pulse generators from three different manufacturers were used. In 39 patients, a complete nonthoracotomy lead system was used. The perioperative mortality was 1.3%. Of these 154 patients, 37% experienced late postoperative problems. Twenty-one patients required system revision within 36.5 months (mean, 8.57 +/- 11.3) of surgery. Reasons for revision were spurious shocks due to electrode fractures (3) or electrode adapter malfunction (2), inadequate signal from endocardial rate-sensing electrodes (3), superior vena cava or right ventricular coil migration (5), failure to correct tachyarrhythmias due to a postimplant rise in defibrillation threshold (5), or pulse generator failure (3). One of these patients required system removal for infection after revision of an endocardial lead. A further 32 patients received inappropriate shocks for atrial fibrillation with a rapid ventricular response or sinus tachycardia. Two of these patients also received shocks for ventricular tachycardia initiated by antitachycardia pacing triggered by atrial fibrillation. Ventricular pacing for bradycardia was associated with inappropriate shocks due to excessive autogain in 2 patients.
CONCLUSIONS
Despite the major diagnostic and therapeutic advantages of tiered-therapy ICDs, a significant proportion of patients continue to experience hardware-related complications or receive inappropriate shocks.
自动植入式心脏复律除颤器：恶性室性心律失常患者的疗效、并发症和生存率。
影响因子：
24
作者：
Kelly,PA;Cannom,DS;Garan,H;Mirabal,GS;Harthorne,JW;Hurvitz,RJ;Vlahakes,GJ;Jacobs,ML;Ilvento,JP;Buckley,MJ
通讯作者：
Buckley,MJ