ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Clinical Follow-up For Icd’s
Dr. Özcan YÜCEL,a Dr. Baybars TÜREL,a Dr. İlker ÖZER,a Dr. Barbaros DOKUMACI,b
aKardiyoloji ve Klinik Elektrofizyoloji Laboratuvarı, Eskişehir Anadolu Hastanesi, ESKİŞEHİRbKardiyoloji ve Klinik Elektrofizyoloji Laboratuvarı, Özel Bordo Kalp Hastanesi, BURSA
day ICD’s are used in the treatment of life-threatening ventricular arrhythmias. While technologic improvements make devices more complex, they make follow-ups more difficult. ICD follow-ups start just after devices implantations. To search for early complications, x-ray and echocardiographic examinations are made before patients are discharged. Then device pockets are controlled.
Initially, ICD devices have to be programmed just for bradikardi parameters and shock only. After the first shock, ICD’s antitachycardia pacing property can be used.
ICD follow-ups have to be made in places where interferences can be made whenever needed. These places have to be near coronary care unit or reanimation units. In the follow-ups detailed history must be taken before examining the patient.
ICD follow-ups are started by searching the pockets carefully. During device interrogations, all information about devices and treatments until that time must be evaluated. Later, with a suitable programmer devices are interrogated. It is strictly necessary to control programmed parameters suck as arrhythmia diagnostic criteria, treatment algorithms, bradikardia and tachycardia treatment programs. Lead impedance, battery voltage, capacitor charging time and lead output voltages are measured. The reason of a lead impedance, decrease might be an insulation problem, while a lead fracture might be the indicative of a lead impedance increase.
Arrhythmia records in device memory have to be searched carefully and treatments have to be programmed depending on the records. After the last symptomatic arrhythmia patients discourage to drive a motor vehicle for a time period of at less 3 months or preferably 6 months.
Patients must be informed about electromagnetic services, work conditions and precautions for device infections. Patient education and psycholological support must be continued in all stages. Patients must be taught how to behave when faced with a shock.
It must not be forgotten that there may be either false shocks or ''Fantom şok''. After the first shock patient must go to a cardiology center not later than 1 or 2 days. If the number of shocks in 24 hours are 2 or more, the patient must go to an emergency room immediately.Keywords: ICD, clinical follow-upTurkiye Klinikleri J Int Med Sci 2005, 1(24):49-54
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