Zephyr5826起搏器心房自动阈值管理的临床观察

目的动态观察Zephyr5826起搏器心房自动阈值管理(ACM)功能的开启情况、准确性及安全性。方法选取置入Zephyr5826起搏器患者68例,于置入术后第1,7天及1,2,3,6个月时随访程控,观察ACM功能的开启情况,手工测试心房起搏阈值并与ACM功能测定的值进行比较。结果 68例均完成随访。随访期内35例(51.50%)成功开启ACM功能,其中术后第1,7天及1,2,3个月时开启例数分别为14例(20.6%)、21例(30.9%)、26例(38.2%)、28例(41.2%)和32例(47.1%)。手工测试与ACM测试的心房阈值无差异。33例因起搏器自动测定心房刺激除极波(ER)过小不推荐开启ACM功能。随访期间心电图及动态心电图(Holter)均未见心房失夺获及感知不良。与普通电压和高电压起搏相比,自动阈值管理功能在心房输出方面分别节省50%,88%的能量消耗。结论 Zephyr5826起搏器ACM功能可以安全有效的应用低能量起搏心脏。部分患者术后因起搏器测定心房ER过小未能开启ACM功能,但在随访过程中ACM的开启比例逐渐升高。

The clinical observation of the atrial capture management in Zephyr5826 pacemaker

Objective To observe the effect of the atrial capture management(ACM) in Zephyr5826 pacemaker.Methods Sixty-eight patients were implanted Zephyr5826 pacemaker.The operation of ACM function was observed and the atrial thresholds tested manually were compared with that tested by ACM function at the time of 1 day,7 days,1 month,2 months,3 months and 6 months after implantation.Results Sixty-eight patients finished the follow-up.14,21,26,28,32 and 35 patients′ function were turned on at the time of 1 day,7 days,1 month,2 months,3 months and 6 months after implantation.The atrial thresholds tested by ACM function had no statistical significant difference with the thresholds tested manually.33 patients′ ACM function could not be turned on due to the insufficient atrial ER.The ECG and Holter monitoring in all patients showed a normal pacing function without loss of capture.Conclusion To test the threshold and reduce the energy output automatically by ACM function are effective and safe in Zephyr5826 pacemaker.The ACM function could not be turned on in several cases patients after implantation due to the insufficient atrial ER,but the percent age of ACM function turn-on increases gradually during the follow-up.