主动固定电极行右室流出道间隔部起搏的临床应用

目的：探讨主动固定电极行右室流出道间隔部起搏临床应用的可行性和安全性及间隔部电极定位固定的技术方法。方法：24例需安装永久起搏器患者采用主动固定螺旋电极在右室流出道间隔部植入,测定有关参数并随访观察。结果：所有患者手术均获成功,未出现严重并发症。起搏阈值（0.45±0.17）V,R波幅度（10.2±2.5）mV,电极导线阻抗（680±120）Ω。起搏心电图Ⅱ、Ⅲ、avF导联的QRS波群直立向上,Ⅰ或AVL导联呈负向波。术后随访起搏良好,胸片无电极脱位,部分合并严重心力衰竭的患者复查心脏超声示心腔缩小,心功能改善。结论：采用主动固定螺旋电极行右室流出道间隔部起搏安全性高、可行性好。

Application of Active Fixation Lead in Patients with Right Ventricular Outflow Septum Pacing

Objective： To investigate the feasibility and methodology of active fixation lead on patients under right ventricular outflow tract septum（RVOTS） pacing.Methods： 24 patients need to install a permanent pacemaker were enrolled.Ventricular active fixation lead was implanted in the RVOTS successively and pacing parameter was tested.Results： All operations were successful and no serious complications.Mean lead threshold was（0.45 ±0.17） V,R-wave amplitude was（10.2±2.5） mV and lead impedance was（680±120） Ω.Pacing ECG showed that the QRS wave was positive in Ⅱ ,Ⅲ and avF lead, but negative in Ⅰ or AVL lead. Postoperative follow-up showed good pacing, no electrode dislocation by chest X-ray inspection. Echocardiography showed ventricular narro- wing and improvement of cardiac function in some patients with severe heart failure. Conclucion： The RVOTS pacing with active fixa- tion lead is feasible and safe.