3830主动固定起搏导线在右室间隔部起搏的临床应用

目的观察3830主动固定起搏导线（美国美敦力公司）在临床心脏起搏治疗中的可行性、安全性。方法46例符合起搏器植入适应证患者,随机分为3830组（n=23）和5076组（n=23）,3830组心室使用3830导线,5076组心室使用5076导线。采用VVI或DDD起搏模式,心室导线均放置在右室间隔部,观察两组在术中及术后1、3个月各项心室导线参数情况以及有无并发症。结果两组患者均顺利完成起搏器植入手术,术中及术后均无并发症发生。3830组手术时间略长于5076组（64.6±3.5）min vs（58.3±4.2）min,P〈0.05],但X线曝光时间无差异。与5076组相比,3830组术中及术后1、3个月的心室参数无差异。结论 3830主动固定起搏导线用于选择右室间隔部起搏是安全、可行的。

Clinical application of 3830 active fixation leads from right ventricniar septum

Objective To investigate the feasibility and safety of Medtronic 3830 active fixation leads with ventricular pacing. Methods Forty-six patients with pacemaker implantation indication were randomized into two groups. One ＇group underwent ventricular pacing with Medtronic 3830 active fixation leads and the other group with Medtronic 5076 fixation leads, regardless the type of atrial leads. All active fixation leads were localized at right ventricular septum, with VVI or DDD modes. The parameters of two groups were recorded during and after procedure and compared accordingly. Results Pro- cedures in two groups came off smoothly and there were no subjects with complications. There were longer operation time in 3830 lead group than in 5076 lead group （64.6±3.5）min vs （58.3±4.2）min, P〈0.05 ]. However, there was no signifi- cant difference in exposure time between two groups. There was no significant difference in pacing threshold, impedance and sensation l~etween two groups during procedure and 1 month or 3 months after the procedure. Conclusion It is feasible to pace from right ventricular septum with active fixation leads if a careful choice is made.