CAJ | 학술논문

探讨经皮下隧道左室电极重置1例的临床治疗效果，该患者以Ⅰ类适应症植入CRT，在4年的随访中患者心衰症状改善，左室射血分数有所改善，但更换脉冲发生器后出现左室电极失夺获，提示心脏起搏器术后及时随访程控是必要的。患者CRT植入术后4年，无ICD放电治疗史，但重置电极过程中发现上腔静脉狭窄，提示常规起搏治疗有发生静脉狭窄可能，特别是多根电极经同一血管植入心腔时血管狭窄发生率更高。该患者经右锁骨下静脉置入电极并经皮下隧道至左锁骨下连接脉冲发生器，该方法对于不能在同侧植入电极或脉冲发生器的特殊患者是一条解决方案。
탐토경피하수도좌실전겁중치1례적림상치료효과，해환자이Ⅰ류괄응증식입CRT，재4년적수방중환자심쇠증상개선，좌실사혈분수유소개선，단경환맥충발생기후출현좌실전겁실탈획，제시심장기박기술후급시수방정공시필요적。환자CRT식입술후4년，무ICD방전치료사，단중치전겁과정중발현상강정맥협착，제시상규기박치료유발생정맥협착가능，특별시다근전겁경동일혈관식입심강시혈관협착발생솔경고。해환자경우쇄골하정맥치입전겁병경피하수도지좌쇄골하련접맥충발생기，해방법대우불능재동측식입전겁혹맥충발생기적특수환자시일조해결방안。
To evaluate left ventricular electrode reset subcutaneous tunnel one case of clinical treatment,the patients with classⅠindication implanted CRT,in four years of fol ow-up of patients with heart failure symptoms,left ventricular ejection fraction improved,However,after the replacement of the left ventricular electrode pulse generator loss of capture,prompt and timely fol ow-up programmable pacemaker surgery is necessary.CRT implantation in patients 4 years,no history of ICD discharge treatment,but the reset electrode found during the superior vena cava stenosis,suggesting that conventional pacing vein stenosis may occur,particularly in a plurality of electrode chambers of the heart through the same vascular implants a higher incidence of vascular stenosis[1,2].The patients with the right subclavian vein placement of electrodes and subcutaneous tunnel to connect the left subclavian pulse generator,during and after both safe and reliable,this method is not for a particular patient or a pulse generator implanted electrodes on the same side is a solution.