起搏器术后发生上腔静脉阻塞综合征和起搏功能障碍介入治疗1例  

One case of superior vena cava occlusion syndrome and pacemaker malfunction associated with leads

作　　者：李燕玲[1] 王博雯[1] 张天成 谢萍[1] LI Yanling;WANG Bowen;ZHANG Tiancheng;XIE Ping(Department of Cardiology,Gansu Province Hospital,Lanzhou,730000,China)

机构地区：[1]甘肃省人民医院心内一科,兰州730000

出　　处：《临床心血管病杂志》2023年第4期324-326,共3页Journal of Clinical Cardiology

摘　　要：永久性人工心脏起搏器植入术后并发上腔静脉阻塞病例虽有报道,但慢性闭塞同时合并起搏功能障碍案例极少。本例患者在植入双腔心脏起搏器术后4年,出现上腔静脉阻塞综合征表现,且起搏器程控发现心室电极起搏阈值升高至3.5 V仍有间歇性心室失夺获。肘正中静脉造影提示左锁骨下静脉至上腔静脉段完全闭塞,侧支循环丰富。本病例采用介入球囊扩张技术,开通闭塞血管段,徒手拔除原心室电极,同侧植入新心室电极。术后起搏器功能正常,临床症状缓解,治疗效果理想。Superior vena cava(SVC)occlusion has been reported after permanent pacemaker implantation,but chronic occlusion combined with pacing dysfunction is rare.The patient occurred SVC obstruction syndrome 4 years after implantation of a double-chamber pacemaker,and the pacing threshold of the ventricular electrode was increased according to the pacemaker programming.Median cubital venography showed complete occlusion of the left subclavian vein with abundant collateral circulation.In this case,we used the interventional balloon dilation technique to recover the occluded vessel segment,remove the original ventricular electrode by hand,and implant the new ventricular electrode.Eventually,we successfully treat this patent and relieve the symptoms of SVC.

关 键 词：心脏起搏器 锁骨下静脉 上腔静脉阻塞综合征 球囊扩张 

分 类 号：R541.7[医药卫生—心血管疾病]