心外膜电极在心脏永久起搏中的应用

目的评估心外膜电极放置的可行性及安全性。方法对14例因不适合植入心内膜电极的患者放置心外膜电极,分析心外膜电极的外科手术植入情况、术后随访患者病情以及起搏参数变化。结果 14例共植入18根心外膜电极,其中右房电极4根,右室电极10根,左室电极4根。心脏手术者经胸部正中切口路径10例,采用左侧第4～5肋间切口路径4例。手术均顺利完成。术后平均随访12.5个月,1例CRT患者死于心力衰竭。所有患者无电极断裂及手术伤口感染发生;起搏阈值、感知参数及电极阻抗均正常。结论植入心外膜电极是可行且安全的。

Clinical application of permanent epicardial leads in cardiac pacing

Objective To assess the feasibility and safety of permanent epicardial pacing. Methods Fourteen patients who, were not suitable for the endocardial leads, and were implanted with permanent epicardial pacemakers were reviewed. We analyzed all the surgical operation records and viewed the changes of the patients＇ illness as well as the parameters of the permanent cardiac pacemakers in follow-up. Results The fourteen patients had a total of 18 permanent epicardial pacing leads, including 4 right atrium leads, 10 right ventricular leads and 4 left ventricular leads. Out of the 14 operations, 10 patients had their implantation via midline thoracotomy and the other 4 operations were taken via left anterlateral stemotomy. All surgical epicardial electrode lead were successfully implanted. Follow-ups were taken at an average interval of 12.5 months. One CRT patient died of congestive heart failure. No lead fracture and infected wound happened to the patients. Impedance, sensing and stimulation thresholds were in the normal range and relatively steady. Conclusion Epicardial lead placement is feasible and safe.