1 023台永久起搏器脉冲发生器更换原因分析

目的:通过回顾性分析起搏器脉冲发生器更换原因,探讨如何避免或减少起搏器非正常更换,使患者获得安全和可靠的起搏治疗. 方法:1977-01-01至2006-12-31间我院共计791例患者更换1 023台起搏器.在1976～1985年、1986～1995年及1996～2005年更换起搏器的台数分别为297台、489台及237台.根据病史、体检,心电图、起搏器程控检查和术中测试等,判断起搏器更换原因.正常更换定义为:电池耗竭和(或)达厂家建议且使用5年及以上. 结果:正常更换共计757台,占74.0%;其它非正常更换原因:电池提前耗竭、起搏系统感染、厂家召回、提前"升级"更换分别占18.8%、3.8%、2.3%、及1.1%.在1976～1985年、1986～1995年及1996～2005年置入的起搏器中,非正常更换占总例数的比例分别为56.9%;10.4%和19.4%;在较早前10年间(1976～1985年)非正常更换率比1986～1995年、1996～2005年明显高(P<0.001).在近10年间置入的起搏器中,厂家召回、电池提前耗竭、起搏系统感染、提前"升级"更换分别占10.1%、5.1%、3.4%和0.8%. 结论:起搏器更换最常见原因为正常电池耗竭,其他非正常原因依次为电池提早耗竭,厂家召回,起搏系统感染和提前升级.

Clinical Analysis of 1 023 Pulse Generator Replacement in 30 Years

Objective:To analyze the cause for pulse generator replacement in order to reduce or avoid abnormal replacement and to ensure the safety and reliability of cardiac pacing. Methods: A total of 1 023 pulse generator replacement in 791 patients from January 1977 to December 2006 in our hospital were analyzed for their symptomatic bradycardia needing. Normal battery depletion was signified for the elective replacement indicator after 5 years of implantation. Results: There were 757 (74% ) patients had normal pulse generator replacement for battery depletion. The abnormal replacement including accelerated battery depletion,pacemaker related infection,manufacturer recall and upgrade in advance were 18. 8% , 3. 8% , 2. 3% , and 1. 1% respectively. In recent 10 years,the abnormal replacement including manufacturer recall,accelerated battery depletion, pacemaker related infection and upgrade in advance were 10. 1% , 5. 1% , 3.4% , and 0. 8% respectively. Conclusion: The most popular reason for generator replacement was normal battery depletion. The abnormal reasons included accelerated battery depletion,manufacturer recall, pacemaker related infection and upgrade in advance.