中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
3期
226-229
,共4页
赵青%沃金善%郭洁%蔡尚郎
趙青%沃金善%郭潔%蔡尚郎
조청%옥금선%곽길%채상랑
起搏器%导线植入%主动固定导线%固定螺旋
起搏器%導線植入%主動固定導線%固定螺鏇
기박기%도선식입%주동고정도선%고정라선
Pacemaker%Lead implantation%Active-fixation lead%Fixed screw
目的 评价固定螺旋主动固定导线(Fineline Ⅱ EZ,美国波科公司)植入术中及术后3个月参数变化情况,评价其安全性.方法 2012年1月至2013年9月在青岛大学附属医院156例缓慢性心律失常患者行单腔或双腔起搏治疗,心室起搏导线均选用固定螺旋主动固定导线,经左或右侧锁骨下静脉置于右心室流出道间隔部,分别于导线旋入心肌即刻、旋入后5 min、术后即刻、术后3个月测试起搏参数:起搏阈值、导线阻抗和R波幅度,并观察术后有无导线脱位、导线穿孔、与经静脉有关的血栓形成及囊袋感染等严重并发症发生.结果 导线旋入即刻起搏阈值较高,5 min后明显下降[(0.76±0.22)V对(0.39±0.13)V,P＜0.001];术后即刻阈值较旋入5 min后进一步下降[(0.35±0.10)V对(0.39±0.13)V,P＜0.001].R波幅度在导线旋入后5 min测试较术后即刻降低[(12.70±4.94)mV对(8.94±4.07) mV,P＜0.001].术后仅1例患者出现导线脱位,无导线穿孔、囊袋感染等并发症发生.结论 固定螺旋主动固定导线旋入心肌5 min后起搏阈值明显降低,故可常规于旋入5min后进行测试,确定是否需要调整导线位置.固定螺旋主动固定导线在应用过程中是安全有效的.
目的 評價固定螺鏇主動固定導線(Fineline Ⅱ EZ,美國波科公司)植入術中及術後3箇月參數變化情況,評價其安全性.方法 2012年1月至2013年9月在青島大學附屬醫院156例緩慢性心律失常患者行單腔或雙腔起搏治療,心室起搏導線均選用固定螺鏇主動固定導線,經左或右側鎖骨下靜脈置于右心室流齣道間隔部,分彆于導線鏇入心肌即刻、鏇入後5 min、術後即刻、術後3箇月測試起搏參數:起搏閾值、導線阻抗和R波幅度,併觀察術後有無導線脫位、導線穿孔、與經靜脈有關的血栓形成及囊袋感染等嚴重併髮癥髮生.結果 導線鏇入即刻起搏閾值較高,5 min後明顯下降[(0.76±0.22)V對(0.39±0.13)V,P＜0.001];術後即刻閾值較鏇入5 min後進一步下降[(0.35±0.10)V對(0.39±0.13)V,P＜0.001].R波幅度在導線鏇入後5 min測試較術後即刻降低[(12.70±4.94)mV對(8.94±4.07) mV,P＜0.001].術後僅1例患者齣現導線脫位,無導線穿孔、囊袋感染等併髮癥髮生.結論 固定螺鏇主動固定導線鏇入心肌5 min後起搏閾值明顯降低,故可常規于鏇入5min後進行測試,確定是否需要調整導線位置.固定螺鏇主動固定導線在應用過程中是安全有效的.
목적 평개고정라선주동고정도선(Fineline Ⅱ EZ,미국파과공사)식입술중급술후3개월삼수변화정황,평개기안전성.방법 2012년1월지2013년9월재청도대학부속의원156례완만성심률실상환자행단강혹쌍강기박치료,심실기박도선균선용고정라선주동고정도선,경좌혹우측쇄골하정맥치우우심실류출도간격부,분별우도선선입심기즉각、선입후5 min、술후즉각、술후3개월측시기박삼수:기박역치、도선조항화R파폭도,병관찰술후유무도선탈위、도선천공、여경정맥유관적혈전형성급낭대감염등엄중병발증발생.결과 도선선입즉각기박역치교고,5 min후명현하강[(0.76±0.22)V대(0.39±0.13)V,P＜0.001];술후즉각역치교선입5 min후진일보하강[(0.35±0.10)V대(0.39±0.13)V,P＜0.001].R파폭도재도선선입후5 min측시교술후즉각강저[(12.70±4.94)mV대(8.94±4.07) mV,P＜0.001].술후부1례환자출현도선탈위,무도선천공、낭대감염등병발증발생.결론 고정라선주동고정도선선입심기5 min후기박역치명현강저,고가상규우선입5min후진행측시,학정시부수요조정도선위치.고정라선주동고정도선재응용과정중시안전유효적.
Objective To investigate the pacing parameter changes in different stages during and after the implantation,and evaluate the safety and efficiency of the active-fixation pacing lead (Fineline Ⅱ EZ).Methods One hundred and forty-six patients with bradyarrhythmias and accepted single or dual chamber pacing therapy were included in the Affiliated Hospital of Qingdao University from January 2012 to septermber 2013.Fineline Ⅱ EZ was implanted in all patients through the left or right subclavicular vein and fixed in the right ventricular outflow tract.The pacing parameters,including pacing threshold,R wave amplitude and the electrode impedance,were tested at the moment after screwing the leads and 5 minutes later,immediately after the procedure and 3 months later.Complications such as electrode dislocation,electrodes perforation,intravenous associated thrombosis and pocket infection were also observed in all patients.Results Pacing threshold was tested at the moment after screwing the leads was a bit high (0.76±0.22) V,and decreased 5 minutes later (0.39±0.13) V,(P＜0.001).Further decreasing was observed immediately after procedure (0.35±0.10) V,(P＜0.001),and maintained stable after 3 months (0.34±0.10) V,(P=0.252).The electrode impedance was tested at the moment after screwing leads and 5 minutes later,immediately after the procedure and 3 months later.No significant difference was found in R wave amplitude at immediately after the procedure and 3 months later.Only 1 patient had electrode dislocation,no electrode perforation,infection and other complications were observed during the follow-up period.Conclusion For the Fineline Ⅱ EZ,the pacing threshold reduced significantly 5 minutes later compared to the moment after screwed.So it is appropriate to test the pacing threshold 5 minutes after screwing the lead and to determine whether to adjust the electrode position or not.Fineline Ⅱ EZ,the active-fixation pacing lead,is safe and efficient in the clinical application.
