采用螺旋电极行房间隔起搏的初步临床观察

目的探讨采用螺旋电极行房间隔起搏的可行性及安全性。方法需行DDD起搏的患者40例分为两组:房间隔组20例采用螺旋电极行房间隔起搏;右心耳组20例采用翼状被动固定电极行右心耳起搏。总结手术方法 ,观察两组起搏参数及心功能指标的变化。结果两组手术即刻及术后随访的起搏参数稳定,两组间无差异。随访12.43±2.85个月,房间隔组起搏后NYHA心功能分组Ⅰ、Ⅱ、Ⅲ级分别为18,2,0例,而右心耳组则分别为12,7,1例,两组比较差异有显著性(P0.05)。房间隔组左房内径和左室舒张未期内径小于右心耳组((32.5±5.5mmvs33.8±5.2mm,42.4±5.1mmvs47.3±6.8mm,P均0.01),左室射血分数则高于右心耳组((0.65±0.07vs0.62±0.08,P0.05)。结论房间隔起搏安全、可行,起搏参数稳定。

The preliminary clinical experience of interatrial spetum pacing with active fixation lead

Objective To evaluate the feasibility and safety of interatrial spetum （IAS） pacing with active fixation lead. Methods Forty patients were randomized to either the IAS pacing group with active fixation lead or right auricular （RAA） pacing group with passive lead. The operation methods of IAS pacing were investigated and evaluated. The pacing parameters and heart function and operation methods were observed during follow-up phase. Results No difference of pacing parameters between the two groups was found. After follow-up of 12.43 ± 2.85 months, IAS pacing group had 18 patients with NYHA Ⅰ and 2 patients with NYHA Ⅱ , but RAA pacing group had 12 patients with NYHA I , 7 patients with NYHA Ⅱ , and 1 patient with NYHA Ⅲ. There were notable difference between the two groups （P 〈 0.05 ）. IAS pacing group had lower LAD and LVDd than RAA pacing group（ 32.5 ± 5.5 mm vs 33.8 ± 5.2 mm,42.4 ± 5.1 mm vs 47.3 ± 6.8 mm,respectively P 〈 0.01 ）. LVEF of IAS pacing group was higher than RAA pacing group（0.65 ± 0.07 vs 0.62 ± 0.08,P 〈 0.05）. Conclusions IAS pacing is safe and feasible. The paremeters of IAS pacing are stable.