螺旋电极在右室流出道高位室间隔起搏中的临床应用

目的探讨螺旋电极在右室流出道高位室间隔起搏中的应用。方法对有植入永久起搏器适应证的缓慢心律失常患者42例,随机分为2组,22例用主动螺旋电极植入右室高位室间膈（高位室间隔组）。20例用被动电极植入右室心尖部（右室心尖组）。记录2组术中术后各项参数、心电图QRS波宽度及并发症。结果 2组均顺利完成手术,未出现严重并发症,室间膈组电极植入15min后较植入即刻的起搏阈值明显下降[（0.71±0.11）vvs（0.97±0.13）v,P〈0.05]。起搏的QRS波时限较心尖部变窄[（124.77±11.35）msvs（149.28±12.51）ms,P〈0.05]。术后1、3个月随访2组的起搏阈值、阻抗、感知无差异。结论初步证明使用螺旋电极在右室流出道高位室间隔起搏是稳定、安全、可靠的。

Application of Spiral Electrode in 12 Patients with High Right Ventricular Septum Pacing

Objective To investigate the application of high right ventricular septal（HRVS）pacing with spiral electrode.Methods Fourty-two cases implanted pacemaker for bradyarrhythmia were randomly divided into HRVS group（22 patients）,which was paced by spiral electrode from the right ventricular outflow tract septum,and right ventricular apex（RVA） group（20 patients）,paced passive electrode from the right ventricular apex,according to the position of ventricular electrode.The two groups＇ parameters,QRS width and complications before and after the operation were recorded.Results Two groups came through the operation successfully with no serious complications.At 15 minutes after the HRVS group＇ electrode was planted,the pacing threshold dropped significantly compared with the one done immediately[（0.71±0.11）v vs（0.97±0.13）v,P0.05]。The QRS width of HRVS group was narrower than that of RVA group（124.77±11.35）ms vs（149.28±12.51）ms,P0.05]。There was no significant difference in the pacing threshold,impedances and atrial sense between two groups after 1 and 3-month during the follow up period.Conclusion The high right ventricular septum pacing by spiral electrode is steady,safe and feasible.