Erschienen in:
01.02.2009 | CLINICAL CORRESPONDENCE
Twiddler’s syndrome in an adolescent patient with ICD during neurological and physical rehabilitation
verfasst von:
Dr. med. Joerg Herold, MD, Michael Guenther, MD, Ruth H. Strasser, MD, PhD, Martin Braun, MD, PhD
Erschienen in:
Clinical Research in Cardiology
|
Ausgabe 2/2009
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Excerpt
Sirs: A 20-year-old woman was admitted to our hospital by the emergency physician after resuscitation in cardiac arrest due to a ventricular fibrillation (VF) caused by a non-classified cardiomyopathy with a impaired left ventricular function of about 35% and a long QT-syndrome. As a consequence of cerebral hypoxia the patient suffered from an impaired neurological status with cognitive deficit and sensomotoric disability. After 6 weeks of hospitalization good neurological potential was predicted and a single chamber ICD (Guidant/CPI Prizm VR) was implanted for secondary prevention of ventricular fibrillation [
4]. The transvenous defibrillation lead (Guidant, Endotak Reliance) was inserted into the right ventricle via the right subclavian vein, since the left side had been affected earlier by a catheter associated thrombosis. The screw-in lead tip was positioned at the lower interventricular septum with a sensing of 12 mV and a pacing threshold of 0.4 V/0.4 ms. The sleeve was sutured with a 3. 0 non-resolvable twine (Ethibond) and the ICD device positioned subcutaneously. The correct position of the device and the lead was confirmed by a posterior-anterior and lateral chest X-ray, followed by a satisfactory postoperative device interrogation and satisfactory wound healing. …
