title: [The implant of a pacemaker cardioverter-defibrillator with a system of endocardial electrodes without thoracotomy].
abstract: 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.
authors.affiliation: Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors.forename: J A
authors.initials: JA
authors.lastname: González-Hermosillo
authors.forename: V
authors.initials: V
authors.lastname: Medina
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-Ríos
authors.forename: F
authors.initials: F
authors.lastname: Rey
authors.forename: S
authors.initials: S
authors.lastname: Estrada
authors.forename: A
authors.initials: A
authors.lastname: Garrido
authors.forename: A
authors.initials: A
authors.lastname: Alcedo
authors.forename: R
authors.initials: R
authors.lastname: Robledo
authors.forename: G
authors.initials: G
authors.lastname: Rodríguez
authors.forename: S
authors.initials: S
authors.lastname: Kershenovich
mesh_terms: 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
vernacular_title: El implante de un marcapaso-cardioverter-desfribilador sin toracotomía con un sistema de electrodos endocárdicos.