中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2013年
2期
123-126
,共4页
易桂斌%殷泉忠%陆叶%李健%张华%崔俊友
易桂斌%慇泉忠%陸葉%李健%張華%崔俊友
역계빈%은천충%륙협%리건%장화%최준우
起搏%主动固定导线
起搏%主動固定導線
기박%주동고정도선
Pacing%Active fixation lead
目的 观察主动固定起搏导线(3830,美国美敦力公司)在临床心脏起搏治疗的可行性、安全性.方法 40例符合起搏器植入适应证患者,随机分为主动固定导线组(n=20)和普通导线组(n=20),采用VVI或DDD起搏模式,心室导线均放置在右心室间隔部,观察两组在术中及术后各项心室导线参数情况以及有无并发症.结果 两组患者均顺利完成起搏器植入手术,术后均无导线脱位或穿孔发生.主动固定导线组术后并发肺栓塞2例,且X线曝光时间[(10.8±4.4) min对(7.3±2.8)min,P＜0.01]明显延长.与普通导线组相比,主动固定导线组术中及术后1、3个月的心室起搏阈值[(0.52±0.23)V对(0.60±0.17)V,(0.51±0.07)V对(0.50±0.04)V,(0.52±0.13)V对(0.54±0.18)V]、阻抗[(785±152)Ω对(797± 153)Ω,(542±.100)Ω对(560±110)Ω,(510±113)Ω对(558±107) Ω]；R波振幅[(11.24±4.9)mV对(10.52±4.3)mV,(11.16±2.34) mV对(11.31±1.86) mV,(11.31±2.26)mV对(11.72±1.68) mV],差异均无统计学意义(P＞0.05).结论 3830型主动固定起搏导线用于选择右心室间隔部起搏是可行的,但应谨慎选择.
目的 觀察主動固定起搏導線(3830,美國美敦力公司)在臨床心髒起搏治療的可行性、安全性.方法 40例符閤起搏器植入適應證患者,隨機分為主動固定導線組(n=20)和普通導線組(n=20),採用VVI或DDD起搏模式,心室導線均放置在右心室間隔部,觀察兩組在術中及術後各項心室導線參數情況以及有無併髮癥.結果 兩組患者均順利完成起搏器植入手術,術後均無導線脫位或穿孔髮生.主動固定導線組術後併髮肺栓塞2例,且X線曝光時間[(10.8±4.4) min對(7.3±2.8)min,P＜0.01]明顯延長.與普通導線組相比,主動固定導線組術中及術後1、3箇月的心室起搏閾值[(0.52±0.23)V對(0.60±0.17)V,(0.51±0.07)V對(0.50±0.04)V,(0.52±0.13)V對(0.54±0.18)V]、阻抗[(785±152)Ω對(797± 153)Ω,(542±.100)Ω對(560±110)Ω,(510±113)Ω對(558±107) Ω]；R波振幅[(11.24±4.9)mV對(10.52±4.3)mV,(11.16±2.34) mV對(11.31±1.86) mV,(11.31±2.26)mV對(11.72±1.68) mV],差異均無統計學意義(P＞0.05).結論 3830型主動固定起搏導線用于選擇右心室間隔部起搏是可行的,但應謹慎選擇.
목적 관찰주동고정기박도선(3830,미국미돈력공사)재림상심장기박치료적가행성、안전성.방법 40례부합기박기식입괄응증환자,수궤분위주동고정도선조(n=20)화보통도선조(n=20),채용VVI혹DDD기박모식,심실도선균방치재우심실간격부,관찰량조재술중급술후각항심실도선삼수정황이급유무병발증.결과 량조환자균순리완성기박기식입수술,술후균무도선탈위혹천공발생.주동고정도선조술후병발폐전새2례,차X선폭광시간[(10.8±4.4) min대(7.3±2.8)min,P＜0.01]명현연장.여보통도선조상비,주동고정도선조술중급술후1、3개월적심실기박역치[(0.52±0.23)V대(0.60±0.17)V,(0.51±0.07)V대(0.50±0.04)V,(0.52±0.13)V대(0.54±0.18)V]、조항[(785±152)Ω대(797± 153)Ω,(542±.100)Ω대(560±110)Ω,(510±113)Ω대(558±107) Ω]；R파진폭[(11.24±4.9)mV대(10.52±4.3)mV,(11.16±2.34) mV대(11.31±1.86) mV,(11.31±2.26)mV대(11.72±1.68) mV],차이균무통계학의의(P＞0.05).결론 3830형주동고정기박도선용우선택우심실간격부기박시가행적,단응근신선택.
Objective To investigate the feasibility and safety of Medtronic 3830 active fixation leads with ventricular pacing.Methods Forty patients with pacemaker implantation indication were randomized into two groups.One group underwent ventricular pacing with Medtronic 3830 active fixation leads and the other group with Medtronic 5076 fixation leads,regardless the type of atrial leads.All active fixation leads were localized at right ventricular septum,with VVI or DDD modes.The parameters of two groups were recorded during and after procedure and compared accordingly.Results Procedures in two groups came off smoothly and there were no subjects with lead dislocation or perforation.There were 2 patients with pulmonary embolism in 3830 lead group,and with longer exposure time[(10.8±4.4)min vs(7.3±2.8) min,P＜0.01].There was no significant difference in pacing threshold,impedance and sensation between two groups during procedure and 1 month or 3 months after the procedure.Conclusion It is feasible to pace from fight ventricular septum with active fixation leads,if a careful choice is made.
