Avtor/Urednik		Dreisiebner, Gordana; Kamenik, Borut; Sinkovič, Andreja
Naslov		Pericardial effusion after temporary transvenous pacemaker implantation - a case report
Tip		članek
Vir		Slov Kardiol
Vol. in št.		Letnik 5, št. 1
Leto izdaje		2008
Obseg		str. 64-67
Jezik		eng
Abstrakt		Temporary pacing is indicated in severe hemodynamic impairment due to sudden onset of acquired bradyarrhythmias. Complications associated with temporary pacing implantation can occur either during or after implantation. Among the most frequent serious complications are lead displacement and dysfunction, catheter knotting, ventricular arrythmia, inadequate stimulation, thrombosis, infection and septal or ventricular wall perforation. The paper presents a patient with a sudden onset of pericardial effusion after temporary transvenous pacemakerimplantation due to perforation of the right ventricular arrhythmia and arterial hypotension. He was treated with an IV infusion of fluids and pacemaker lead displacement. The epidemiology , management and clinical consequences of perforation, especially cardiac tamponade, are discussed. It was concluded that patients should be closely observed during and after temporary transvenous pacemaker implantation. Echocardiography is important, but the clinical situation necessitates urgent therapeutic procedures.
Izvleček		Začasni spodbujevalec srca je potreben v primeru hemodinamske ogroženosti bolnika zaradi nenadnega nastanka bradikardne motnje srčnega utripa. Zapleti pri vstavitvi začasnega spodbujevalca se lahko pojavijo med ali po posegu. Med najpogostejšimi resnimi zapleti so dislokacija in odpoved delovanja elektrode, vozlanje elektrode, prekatne aritmije, neustrezna stimulacija, tromboza, infekcija in perforacija septuma ali stene srca. Predstavljamo bolnika z nenadnim nastankom perikardialnega izliva po vstavitvi začasnega spodbujevalca srca zaradi perforacije stene desnega prekata, ki se je manifestirala s prekatnimi aritmijami in arterijsko hipotenzijo. Bolnik je bil zdravljen z infuzijo tekočin in spremembo lege elektrode srčnega spodbujevalca. Predstavljena je epidemiologija, zdravljenje in klinične posledice perforacije stene srca, posebno srčna tamponada. Naši zaključki so, da je potrebno bolnika med in po vstavitvi začasnega spodbujevalca srca intenzivno opazovati. Ehokardiografija je pomembna metoda, vendar klinična slika narekuje urgentne ukrepe zdravljenja.
Deskriptorji		PERICARDIAL EFFUSION HEART INJURIES ARRHYTHMIA CARDIAC PACING, ARTIFICIAL HYPOTENSION ECHOCARDIOGRAPHY