主动固定电极导线行心脏特殊部位起搏的临床应用

目的探索主动固定电极导线行心脏特殊部位起搏临床应用的可行性和安全性。方法需要安置心脏起搏器患者88例,其中男54例、女34例,年龄67.6±24.3(28～91)岁。患者为缓慢性心律失常或者严重心力衰竭,放置主动固定电极导线,测定有关参数并随访观察。结果手术顺利完成,未出现严重并发症。共使用主动电极导线151根,其中心室电极导线88根(右室流出道间隔部80根,右室流入道间隔部5根,右室中间隔3根);心房电极63根(右心耳37根,低位房间隔10根,高位房间隔10根,心房侧壁6根)。起搏参数在电极导线置入15min后可达到理想值。术后7天及出院后1,3,6个月随访无电极导线脱位,起搏参数与置入时比较没有差异。结论使用主动固定电极进行心脏特殊部位起搏是可行和安全的。

The feasibility and safety in patients with special cardiac site pacing by active fixed lead

Objective To investigate the feasibility and safety in patients with special cardiac site pacing by active fixed leads.Methods Eighty-eight patients(M/F=54/34,age 67.6±24.3 years old)were implanted active fixed leads for permanent pacemaking of bradycardia and chronic heart failure and some parameters were measured.Results All cases came through the operation successfully with no serious complications.151 active fixed leads were used,including 88 ventricular leads and 63 atrial leads,the active fixed leads were screwed in the right ventricular outflow tract septum(80 cases),the right ventricular inflow tract septum(5 cases),the right ventricular intermediate septum(3 cases),right atrial appendage(37 cases),low right atrial septum(10 cases),high right atrial septum(10cases),right atrial free wall(6 cases).The patients were followed up in 7 days after being implanted and 1,3,6 months after being discharged.The active fixed lead threshold in 15 minutes after being implanted reached ideal level and did not show a significant difference in follow-up period.Conclusion The special cardiac site pacing by the activce fixation lead is feasible and safe.