永久性心脏起搏器植入术中发生心房纤颤时心房电极导线定位经验

目的:研究永久性心脏起搏器植入术中心房纤颤(房颤)发作时以右心房波振幅最大处为右心房电极导线固定位置的可行性。方法:22例房颤发作时植入右心房电极导线的患者术中,测试右心房波振幅,术后随访恢复窦性心律(窦律)时测试右心房波振幅、起搏阈值,2者进行对比分析。结果:房颤心律时,所测得的右心房振幅与转为窦律后所测得的右心房波振幅有较好相关性,2者差异无统计学意义(2.4±1.0)mv比(2.7±1.2)mv,P>0.05]。房颤时术中右心房波振幅平均(2.4±1.0)mv(1.6～3.7mv)者,在房颤转为窦律后所测定的心房感知和起搏功能良好。结论:在房颤发作时,右心房波振幅作为永久心脏起搏器合适的感知及起搏参数,有一定的临床实用价值。

Location experience of atrial electrode for permanent cardiac pacemaker implantation with an attack of paroxysmal atrial fibrillation

Objective:To study the implantation feasibility of right atrial electrode depended upon the biggest atrial amplitude during an attack of atrial fibrillation.Method:Right atrial electrodes were implanted in 22 patients with atrial fibrillation. At the follow-up of postimplantation,1 month,3 month,6 month,we measured and analyzed the right atrial amplitude and threshold when converted to sinus rhythm.Result:There was good relationship of right atrial amplitude when compared atrial fibrillation with sinus rhythm (2.4±1.0)mv vs (2.7±1.2)mv,P>0.05).The right atrial amplitudes were (2.4±1.0)mv(1.6～3.7 mv) at an attack of atrial fibrillation,and the function of atrial sense and pace was good after converting to sinus rhythm.Conclusion:Right atrial amplitude was applicable parameter for permanent cardiac implantation during an attack of atrial fibrillation.