PDF(Pubmed)
Abstract：
UNASSIGNED: Implantable cardioverter-defibrillator (ICD) implantation is a key therapeutic option in arrhythmogenic right ventricular cardiomyopathy (ARVC) to prevent sudden cardiac death due to ventricular tachycardia (VT) and fibrillation (VF). However, sub-optimized R-wave sensing due to myocardium loss interferes with VT/VF identification and appropriate therapy. We tried to implant a 3830 lead to the left ventricular septum (LVS) to facilitate ICD sensing in an ARVC patient.
UNASSIGNED: A 68-year-old woman diagnosed with ARVC was scheduled to undergo ICD implantation. Initially, no sites with suitable R-wave amplitudes were found in the right ventricle (RV) to deploy the defibrillation lead (<3.0 mV). It was likely due to severe RV involvement, but the LVS myocardium was more preserved based on cardiac magnetic resonance imaging. Therefore, we implanted a 3830 lead into the deep area of the septum to facilitate R-wave sensing. During the procedure from the right to left septum, the R-wave amplitude significantly increased (2.6 to 4.3-7.1 mV). Left ventricular septum pacing was finally achieved with favourable R-wave sensing (9.9 mV 24 h post-operation). The 3830 lead was plugged into the IS-1 port, while the defibrillation lead was plugged into the DF-1 port. After a 4-month follow-up, the R-wave amplitude of the 3830 lead was 11.1 mV.
UNASSIGNED: When the R-wave sensing is not acceptable for ICD implantation in ARVC patients, it is critical to assess myocardial conditions comprehensively. If the septal myocardium is preserved, implanting a 3830 lead to the deep or LVS is feasible to improve R-wave sensing.
UNASSIGNED: A 68-year-old woman diagnosed with ARVC was scheduled to undergo ICD implantation. Initially, no sites with suitable R-wave amplitudes were found in the right ventricle (RV) to deploy the defibrillation lead (<3.0 mV). It was likely due to severe RV involvement, but the LVS myocardium was more preserved based on cardiac magnetic resonance imaging. Therefore, we implanted a 3830 lead into the deep area of the septum to facilitate R-wave sensing. During the procedure from the right to left septum, the R-wave amplitude significantly increased (2.6 to 4.3-7.1 mV). Left ventricular septum pacing was finally achieved with favourable R-wave sensing (9.9 mV 24 h post-operation). The 3830 lead was plugged into the IS-1 port, while the defibrillation lead was plugged into the DF-1 port. After a 4-month follow-up, the R-wave amplitude of the 3830 lead was 11.1 mV.
UNASSIGNED: When the R-wave sensing is not acceptable for ICD implantation in ARVC patients, it is critical to assess myocardial conditions comprehensively. If the septal myocardium is preserved, implanting a 3830 lead to the deep or LVS is feasible to improve R-wave sensing.
摘要：
UASSIGNED：植入式心律转复除颤器（ICD）植入是致心律失常性右心室心肌病（ARVC）的关键治疗选择，可防止室性心动过速（VT）和纤颤（VF）导致的心源性猝死。然而,由于心肌丢失导致的亚优化R波感知干扰VT/VF识别和适当的治疗。我们试图将3830导线植入左心室隔膜（LVS），以促进ARVC患者的ICD感应。
UNASSIGNED：一名被诊断为ARVC的68岁女性计划进行ICD植入。最初，在右心室(RV)中未发现具有合适R波振幅的部位展开除颤导线(<3.0mV).这可能是由于严重的房车介入，但根据心脏磁共振成像,LVS心肌保留得更多.因此,我们在隔膜的深处植入了3830导线，以促进R波感应。在从右至左隔膜的手术过程中，R波振幅显着增加（2.6至4.3-7.1mV）。最终以良好的R波感知（术后24h9.9mV）实现了左心室间隔起搏。3830导线插入IS-1端口,而除颤导线插入DF-1端口。经过4个月的随访，3830导联的R波振幅为11.1mV.
UNASSIGNED：当R波感应对于ARVC患者的ICD植入不可接受时，全面评估心肌状况至关重要。如果中隔心肌被保留,将3830引线植入深或LVS对于改善R波感测是可行的。
UNASSIGNED：一名被诊断为ARVC的68岁女性计划进行ICD植入。最初，在右心室(RV)中未发现具有合适R波振幅的部位展开除颤导线(<3.0mV).这可能是由于严重的房车介入，但根据心脏磁共振成像,LVS心肌保留得更多.因此,我们在隔膜的深处植入了3830导线，以促进R波感应。在从右至左隔膜的手术过程中，R波振幅显着增加（2.6至4.3-7.1mV）。最终以良好的R波感知（术后24h9.9mV）实现了左心室间隔起搏。3830导线插入IS-1端口,而除颤导线插入DF-1端口。经过4个月的随访，3830导联的R波振幅为11.1mV.
UNASSIGNED：当R波感应对于ARVC患者的ICD植入不可接受时，全面评估心肌状况至关重要。如果中隔心肌被保留,将3830引线植入深或LVS对于改善R波感测是可行的。
