双腔起搏器自动模式转换功能的临床应用

为观察双腔起搏器自动模式转换功能在房性心律失常治疗中的应用效果 ,对置入具自动模式转换功能起搏器的 31例患者分别于术后第 4天、1个月及每隔 3个月进行一次跟踪随访 ,观察房性心律失常的发生情况和起搏器自动模式转换情况及临床症状。全部病例随访 1～ 18个月 ,出现阵发性心房颤动、心房扑动及房性心动过速 76阵次 ,起搏器由DDD(R)自动转换成DDI(R)模式 72阵次 ,患者自觉心悸 8阵次。结论 :自动模式转换功能可使起搏器在患者发作房性心动过速时发挥对心室的保护作用 ,有效避免由于起搏器跟踪快速心房率而造成心室率过快引起的血流动力学改变 ,并能明显减轻心悸等临床症状 ,提高病人的舒适性和安全性。

Application of Automatic Mode Switching in Dual-Chamber Pacemakers

To assess the impact of mode switching algorithms of dual hamber pacemakers on atrial tachyarrhythmia,31 patients implanted dual chamber pacemakers were followed up regularly clinically and with interrogation of the device to observe the incidence of atrial tachyarrhythmia and mode switching events.Results:During 1～18 months of follow up survey,76 times of atrial tachyarrhythmia were detected by the devices,the pacing mode have switched automaticly for 72 times from DDD(R) to a non atrial tracking mode DDI(R).There were 8 times of palpitation which had been felt by the patients.Conclusion:When choosing the most optimal pacing mode,the objective must be to allow the pacemaker to behave as physiologically as possible.This includes the restoration of atrioventricular synchrony and/or rate adaptive pacing wherever needed.Automatic mode switching algorithms can effectively protect against the conduction of atrial tachyarrhythmia to the ventricle by dual chamber pacemakers,also ensure atrioventricular synchrony in the case of a sinus rhythm or relative bradycardia,and eventually maintain the stability of hemodynamics.