CAJ | 학술논문

目的评估植入新型主动固定起搏导线的可用性和安全性。方法选择本中心植入永久性人工心脏起搏器患者101例，分为新型导线组（n=25）和传统导线组（n=76），新型导线组患者植入Medtronic 3830导线3根，5086MRI导线14根（包括心房、心室导线），Boston Scientific4471导线15根；传统导线组患者植入心室主动固定导线76根，心房被动固定导线58根，测量植入后各相关起搏参数，手术时间，曝光时间及心室导线过三尖瓣的次数，并常规随访。结果两组导线的阈值[（0.62±0.14）V、（0.63±0.17）V]、振幅[（11.29±4.28）mV、（12.74±6.08）mV]、阻抗[（767.68±132.73）Ω、（815.14±182.46）Ω]、电流[（0.77±0.19）mA、（0.85±0.33）mA]、斜率（2.46±1.07、2.84±1.02）差异均无统计学意义（均P＞0.05），两组起搏导线损伤电流[（6.83±1.57）mV、（6.61±1.87）mV]、植入手术时间[（44.20±4.65）min、（43.42±5.55）min]、曝光时间[（3.24±1.04）min、（3.33±1.05）min]、导线过三尖瓣次数（1.36±0.57、1.34±0.63）差异均无统计学意义（均P＞0.05）。三种新型起搏导线植入时均未发生并发症，4471导线出现1例术后完全脱位。1年时随访两组导线的阈值、振幅、阻抗异均无统计学意义（均P＞0.05）。结论新型起搏导线均符合起搏器植入要求，未增加手术时间和曝光时间，植入安全。
목적평고식입신형주동고정기박도선적가용성화안전성。방법선택본중심식입영구성인공심장기박기환자101례，분위신형도선조（n=25）화전통도선조（n=76），신형도선조환자식입Medtronic 3830도선3근，5086MRI도선14근（포괄심방、심실도선），Boston Scientific4471도선15근；전통도선조환자식입심실주동고정도선76근，심방피동고정도선58근，측량식입후각상관기박삼수，수술시간，폭광시간급심실도선과삼첨판적차수，병상규수방。결과량조도선적역치[（0.62±0.14）V、（0.63±0.17）V]、진폭[（11.29±4.28）mV、（12.74±6.08）mV]、조항[（767.68±132.73）Ω、（815.14±182.46）Ω]、전류[（0.77±0.19）mA、（0.85±0.33）mA]、사솔（2.46±1.07、2.84±1.02）차이균무통계학의의（균P＞0.05），량조기박도선손상전류[（6.83±1.57）mV、（6.61±1.87）mV]、식입수술시간[（44.20±4.65）min、（43.42±5.55）min]、폭광시간[（3.24±1.04）min、（3.33±1.05）min]、도선과삼첨판차수（1.36±0.57、1.34±0.63）차이균무통계학의의（균P＞0.05）。삼충신형기박도선식입시균미발생병발증，4471도선출현1례술후완전탈위。1년시수방량조도선적역치、진폭、조항이균무통계학의의（균P＞0.05）。결론신형기박도선균부합기박기식입요구，미증가수술시간화폭광시간，식입안전。
Objective To evaluate availability and safety of new active- fixation pacing lead. Methods 101 patients underwent pacemaker implantation at our heart center , of them, 25 cases received new pacing lead (new lead group) , including 3 Medtronic 3830 leads , 14 5086MRI leads (atrial and ventricular leads) and 15 Boston Scientific 4471 leads, the others received 76 ventricular active- fixation leads and 58 atrial passive leads (traditional group). Pacing parameters, operation time, duration of exposure, and the time for lead passing through the tricuspid orifice were recorded. Results The pacing threshold, amplitude, impedance, current, and slope were not significant difference between two groups [ (0.62±0.14) vs (0.63±0.17)V, (11.29±4.28) vs (12.74±6.08)mV, (767.68±132.73) vs (815.14±182.46)Ω, (0.77±0.19) vs (0.85±0.33)mA, (2.46±1.07) vs (2.84±1.02), respectively]. The injury current, operative time, exposure time[(3.24± 1.04) vs (3.33 ±1.05)min], and the time for lead passing through the tricuspid orifice (1.36 ±0.57 vs 1.34 ±0.63)were similar in two groups [(6.83 ±1.57) vs (6.61 ±1.87)mV, (44.20 ±4.65) vs (43.42 ±5.55)min, (3.24 ±1.04) vs (3.33 ±1.05) min, 1.36±0.57vs1.34±0.63, respectively]. There was no serious complication during implantation of new pacing lead. A 4471 model lead dislocated completely after operation. There was no significant difference of threshold, amplitude and impedance between two groups at 1- year fol ow- up (al P>0.05). Conclusion The new pacing leads are safety and meet the requirements of pacemaker implantation, without increasing the operative time and exposure time.