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インプラントされたカーディオバーター-デフィブリレーターを持つ患者のペースメーカー刺激のプロアリズム効果
Ewald Himmrich1, Oliver Przibille, Christian Zellerhoff
1II. Medical Clinic, University Hospital, Langenbeckstrasse 1, D-55131 Mainz, Germany. himmrich@2-med.klinik.uni-mainz.de
Circulation
|July 2, 2003
まとめ
ペースメーカーの刺激は,インプラント可能な kardioverter-defibrillatorsを持つ患者で危険な室内タキアリズムを誘発することができます. ペースメーカーをオフにしたり,より長い脱出間隔をプログラムしたりすることで,これらのペースメーカー誘発の心拍不全を予防できます.
科学分野:
- 電気生理学 電気生理学
- 心臓病学 心臓病学
- 医療機器 医療機器について
背景:
- 埋め込み式心動除細動器 (ICD) は,生命を脅かす心室性タキアリズム症の治療に使用されます.
- ペースメーカー誘発性心拍動症 (PIT) は,ICDとペースメーカーを患っている患者の潜在的な合併症です.
研究 の 目的:
- ICD患者における右心室VVIバックアップペースのプロアリズムの可能性を調査する.
- ペースメーカーの刺激が心室性タキアリズムを誘発できるかどうかを判断する.
主な方法:
- パスメーカー誘発性心拍動症 (PIT) の患者を対象とした前向きのクロスオーバー研究.
- 患者は,ペースメーカーをオフにするか,または60bpmにプログラムするようにランダムに割り当てられ,その後のクロスオーバーが行われました.
- PITの再発を観察するために1年間フォローアップが行われました.
主要な成果:
- 150人の患者のうち,39人 (26%) がPITを経験し,13人 (8.6%) が独占的にPITを経験しました.
- ペースメーカーをオフにすると,PITは発生しませんでした.
- ペースメーカーを60bpmにプログラムすると,6人の患者のうち5人にPITが再発しました.
結論:
- ペースメーカーの刺激は,ICD患者において,PITを誘発する,前動脈リズム効果を有する.
- PITは臨床的症状を引き起こし,抗ヒタヒカルディア治療を誘発する可能性があります.
- PITとペースメーカーの指示がない患者では,デバイスをオフにしたり,最も長い脱出間隔でプログラムする必要があります.
関連する概念動画
01:28Mechanism of Cardiac Arrhythmias
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
01:29Disturbances in Heart Rhythm
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:29Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
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01:25Dysrhythmias VI: Management of Dysrhythmias
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01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
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