VDD起搏系统的临床应用和长期稳定性观察

对25例窦房结功能正常的完全房室阻滞患者采用锁骨下静脉穿刺法,置入了单导线VDD起搏系统,并进行术后长期随访,通过动态心电图进行房室同步的监测。结果:25例均成功置入VDD起搏系统。术中测右房A波感知振幅为2.43±0.75mV。随访期为6个月至4年,术后1周和1,3,6,12个月的P波振幅均小于术中,有显著性差异,P<0.01。术后1周及3,6,12个月动态心电图显示心房同步百分率分别为99.97%±0.01%,99.98%±0.01%,99.98%±0.02%,99.99%±0.01%,各数值间比较无显著性差异。随访中未发生心房感知不良、过感知或起搏器介导性心动过速等并发症。结论:单导线VDD双腔起搏系统具有安装简单、房室同步功能稳定及生理性起搏的特点,适合窦房结功能正常的房室阻滞患者。

Clinical Application and Long-Range Stability Observation of Single Lead VDD Pacing System

A single lead VDD pacing system was implanted in 25 patients with normal sinoatrial node function by subclavian venous puncture. The rate of atrioventricular synchronic pacing was observed by holter monitor during follow-up.Results:VDD pacing system was successfully implanted in 25 patients. The mean amplitude of P wave was 2.43±0.75 mV at implantation, and was significant higher than that of follow-up,P<0.01. The rate of atrioventricular sychronization pacing was 99.97%±0.01%,99.98%±0.01%,99.98%±0.02%,99.99%±0.01% at 1 week,3months,6months,12months respectively. Postoperative complications such as atrial hyposensing, hypersensing and pacemaker mediated tachycardia were not observed. Conclusion: A single lead VDD pacing system is an optimal treatment for patients with high degree AVB and normal sinoatrial node function, which can be easily implanted and maintain steadily atrioventricular sychronization pacing.