[The implant of a pacemaker cardioverter-defibrillator with a system of endocardial electrodes without thoracotomy].
This article describes the first case in Mexico of an implantable pacer-cardioverter-defibrillator in a 44-year-old man with coronary artery disease and recurrent ventricular tachycardia without the need for a thoracotomy and epicardial electrodes. The patient underwent electrophysiological evaluation that revealed drug-refractory ventricular tachycardia. Endocardial catheter ablation with radiofrequency was considered and rejected due to an unstable hemodynamic state during the tachycardia. A triple electrode system using two transvenous catheter electrodes and a subcutaneous chest patch were employed. Two monophasic unsynchronized shocks were delivered with a 18 J sequential pulse technique over two distinct current pathways. The automatic pacer-cardioverter-defibrillator was implanted in the abdominal wall and demonstrated reproducible termination of ventricular fibrillation.
González-Hermosillo
J A
JA
Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Medina
V
V
Martínez-Ríos
M A
MA
Rey
F
F
Estrada
S
S
Garrido
A
A
Alcedo
A
A
Robledo
R
R
Rodríguez
G
G
Kershenovich
S
S
D000328:Adult; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D004566:Electrodes; D005069:Evaluation Studies as Topic; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000628:therapy; D013908:Thoracotomy; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000628:therapy
El implante de un marcapaso-cardioverter-desfribilador sin toracotomía con un sistema de electrodos endocárdicos.