Komplikacije pri ugradnji elektrostimulatora srca

master's thesis

• Title (english): Complications associated with cardiac electrostimulation device implantation
• Author: Jakov Ivanišin
• Mentor: Martina Lovrić Benčić (mentor)
• Committee member: Joško Bulum (predsjednik povjerenstva)
• Committee member: Marko Jakopović (član povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Elektrostimulacija se danas koristi u liječenju bradiaritmija i srčanog bloka. Elektrostimulator srca sastoji se od generatora impulsa i elektroda. Razvojem tehnologije postupno je tekao i razvoj uređaja za elektrostimulaciju srca pa su, s vremenom, osnovnim funkcijama - stimulaciji i zamjećivanju vlastitih impulsa, pridodane i dodatne funkcije, poput prilagođavanja srčane frekvencije. Od samih početaka terapije elektrostimulacijom pa do danas broj ugrađenih elektrostimulatora u neprestanom je porastu zbog povećanja starosti ukupne populacije, razvoja tehnologije i proširenja indikacija. Međutim, u još je izraženijem porastu i broj komplikacija uzrokovanih njihovom ugradnjom. Iako podaci u literaturi o incidenciji komplikacija pri ugradnji elektrostimulatora srca prilično variraju, što je najvjerojatnije uzrokovano različitim definiranjem određenih stanja u pojedinim studijama, općenito se smatra da je incidencija akutnih komplikacija 4-5%, dok je incidencija kroničnih oko 2,7%. Elektrode trajnog elektrostimulatora najčešće se ugrađuju transvenskim putem kroz venu subklaviju ili venu cefaliku, a moguće je i postavljanje epikardijalnih elektroda izravnim postavljanjem na desni atrij i ventrikul minimalno invazivnim tehnikama. Uslijed korištenja venskog pristupa može se razviti pneumotoraks, hematotoraks, zračna embolija i venska tromboza. Komplikacije povezane s ležištem generatora su hematom, erozija i dehiscencija rane, kronična bol i infekcija, dok su one povezane s elektrodama perforacija, malpozicija i dislokacija elektroda.

Abstract (english)

Electrostimulation is the preferred method for treatment of bradyarrhythmia and AV block. Electrostimulation device consists of a pulse generator and electrodes. Technological advancement has influenced the development of electrostimulation devices. The basic functions of the device, pacing and sensing, were upgraded by enabling the device to perform more actions, such as rate-responsive pacing. From the onset of electrostimulation therapy the number of implanted electrostimulation devices has been constantly rising due to an ageing population and developments in the area and because indications have been expanded. However, the increase in the number of complications associated with implantation has been even greater. Although the data that can be seen in the literature largely varies, considering the diverging definitions of certain conditions in different studies, it is considered that the rate of acute complications is 4-5%, while that number for late complications amounts to 2.7%. Electrodes of a permanent electrostimulation device are most commonly implanted via transvenous route, through v. subclavia or v. cephalica. Implantation of epicardial electrodes by placing them directly on right atrium and ventricle using minimally invasive surgery techniques is also possible. When using intravenous techniques, pneumothorax, hemothorax, air embolism and venous thrombosis can occur. Pocket-related complications are hematoma, erosion and wound dehiscence, chronic wound pain, and infection.Lead-related complications are cardiac perforation, malposition and lead dislodgement.

• Keywords: elektrostimulacija; komplikacije
• Keywords (english): electrostimulation; complications
• Language: croatian
• URN:NBN: urn:nbn:hr:105:493216
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-04-13 10:34:58