AICD (automatic implantable cardioverter defibrillator) 植え込み術を施行した特発性心室細動の1例

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  • IDIOPATHIC VENTRICULAR FIBRILLATION TREATED WITH AUTOMATIC IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (AICD)

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A 56-year-old man was admitted to Itsukaichi Memorial Hospital because of syncopal attack. Monitoring ECG revealed that the attack was ventricular fibrillation (Vf). DC shock was applied immediately and he was referred to the hospital for further examination. There was a familiar history that his father and older sister died of cardiac sudden death. His ECG showed normal sinus rhythm, no QT elongation and any other abnormality except bradycardia. Also coronary arteriography and cardiac echo study showed no abnormal findings. Electrophysio-logical study showed normal sinus function and a dual pathway at the atrio-ventricular node. Vf was induced easily with serial stimulation given on the right ventricular outflow tract. The diagnosis was idiopathic Vf, and AICD implantation was indicated.<br> With median sternotomy two patch electrodes and two rate sensing leads were fixed. The generator was inserted under the left abdominal rectal muscle. Postoperative course was uneventful. The patient is followed with medication of procaineamide 1000mg daily and mexiletine 300mg daily.

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