Notfallsituationen bei Trägern von Schrittmachern und implantierten Kardioverter-Defibrillatoren
23. Juli 2012 (online)
Emergency Situations are rare in patients with pacemakers and ICD-devices, but can lead to life-threatening situations and must be treated adequately. Correct assessment of the clinical symptoms and the ECG is most important in these situations.
There are several causes of possible complications in pacemaker- and ICD-therapy. Some complications are more likely in the early period after implantation and are usually recognized before discharge of the patient. Others generally develop after a longer time period and will usually be recognized during pacemaker- and ICD-check-up, but if not, can cause critical patient state and emergency situations. If there is a possible device-dysfunction, it is necessary to organize an immediate interrogation of the device to rule out or confirm this assumption.
Additional diagnostic procedures might be necessary to identify the reasons of dysfunction and plan the correct therapeutic means.
- 1 Pichlmaier M, Marwitz V, Kühn C et al. High prevalence of asymptomatic bacterial colonization of rhythm management devices. Europace 2008; 9: 1067-1072
- 2 Kleemann T, Becker T, Doenges K et al. Annual rate of transvenous defibrillation lead defects in implantable Cardioverter-Defibrillators over a period of > 10 years. Circulation 2007; 115: 2474-2480
- 3 Nowak B, Israel CW, Willems S et al. Empfehlungen zum Einsatz von Eletrokautern bei Patienten mit Herzschrittmachern und implantierten Defibrillatoren. Der Kardiologe 2010; 4: 257-263
- 4 Manegold JC, Israel CW, Ehrlich JR et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: a randomized comparison of monophasic and biphasic schock energy application. Eur Heart J 2007; 28: 1731-1738
- 5 Löschler S, Kohlweyer K, Hartmann A. How safe is external cardioversion on a patient fitted with a cardiac pacemaker? A comparativestudy between the administration of mono- and biphasic shock. Eur Heart J 2006; 27: 466-475
- 6 Manegold JC, Israel CW, Ehrlich JR et al. External cardioversion of atrial fibrillation in patients with implanted pacemaker or cardioverter-defibrillator systems: a randomized comparison of monophasic and biphasic schock energy application. Eur Heart J 2007; 28: 1731-1738
- 7 Levine PA, Barold SS, Fletcher RD et al. Adverse acute and chronic effects of electrical defibrillation and cardioversion on implanted unipolar cardiac pacing systems. J Am Coll Cardiol 1983; 1: 1413-1422