CAJ | 학술논문

目的评价左心室主动固定导线(Starfix 4195美国美敦力公司)在心脏再同步治疗(CRT)中的应用价值.方法分析自2010年7月至2012年8月在浙江大学医学院附属第二医院植入Starfix 4195导线的26例患者,男16例,女10例,平均年龄(68.1±7.7)岁,其中扩张型心肌病16例,缺血性心肌病5例,其他5例.观察Starfix 4195导线植入至最优起搏位点的手术成功率;术后中位随访10.5个月,观察出现左心室导线脱位、膈神经刺激及阈值升高等并发症的发生率.结果 26例患者均成功植入Starfix4195导线,手术成功率100％,24例患者(92.3％)左心室导线植入在最优起搏位点.CRT术后随访时间≥6个月的24例患者中,CRT有反应21例(87.5％),无反应3例(12.5％).术后中位随访10.5个月,左心室导线起搏阈值稳定,与术中比较无明显增高[(1.0±0.5)V对(1.2±0.7)V,P ＞0.05],术后均未出现左心室导线脱位、膈神经刺激等并发症.结论在CRT植入术中,Starfix4195导线能稳定固定在左心室最优起搏位点,明显提高手术成功率,并显著减少术后并发症.
목적 평개좌심실주동고정도선(Starfix 4195미국미돈력공사)재심장재동보치료(CRT)중적응용개치.방법 분석자2010년7월지2012년8월재절강대학의학원부속제이의원식입Starfix 4195도선적26례환자,남16례,녀10례,평균년령(68.1±7.7)세,기중확장형심기병16례,결혈성심기병5례,기타5례.관찰Starfix 4195도선식입지최우기박위점적수술성공솔;술후중위수방10.5개월,관찰출현좌심실도선탈위、격신경자격급역치승고등병발증적발생솔.결과 26례환자균성공식입Starfix4195도선,수술성공솔100％,24례환자(92.3％)좌심실도선식입재최우기박위점.CRT술후수방시간≥6개월적24례환자중,CRT유반응21례(87.5％),무반응3례(12.5％).술후중위수방10.5개월,좌심실도선기박역치은정,여술중비교무명현증고[(1.0±0.5)V대(1.2±0.7)V,P ＞0.05],술후균미출현좌심실도선탈위、격신경자격등병발증.결론 재CRT식입술중,Starfix4195도선능은정고정재좌심실최우기박위점,명현제고수술성공솔,병현저감소술후병발증.
Objective We evaluated the usage of an left ventricular (LV) active fixation lead (Medtronic Attain Starfix4195) in cardiac resynchronization therapy(CRT) implantations.Methods Between July 2010 and August 2012,in 26 patients[16 male,10 female,(68.1±7.7)years,16 dilated cardiomyopathy,5 ischemic cardiomyopathy,5 others],the Starfix4195 lead was used.We observed success rate of implanting the LV lead at the optimal pacing site,and after median follow-up of 10.5 months,and the complications,e.g.lead dislocation,phrenic nerve stimulation and increasing pacing threshold were evaluated.Results Starfix4195 lead implantation was overall successful with 100％,in 24 cases the LV lead was implanted at the optimal pacing site.After a follow-up of over 6 months,21 cases(87.5％)were responsive to CRT while another 3 cases(12.5％) were nonresponse to CRT.After a median follow-up of 10.5 months,the threshold of LV lead remained stable compared to that in surgery [(1.0±0.5) V vs.(1.2±0.7) V,P＞0.05],and no dislocation of LV lead or phrenic nerve stimulation was observed.Conclusion The Starfix4195 lead proved to be an important option in CRT implantations,which can fix to the optimal pacing site steadily,thus significantly increasing surgery success rate as well as decreasing complications.