DDDR起搏器程控功能的临床应用价值

对埋植ＤＤＤＲ起搏器的２１例患者随访２６（６～５４）个月，未见电极移位。２０条激素电极慢性能量阈值为０．４４±０．５１μＪ，有意义地低于１５条螺旋电极的１．８９±１．９８μＪ。通常程控到慢性能量阈值的３倍以获得适当的安全范围，其中６５％的激素电极程控到１．６Ｖ，０．３ｍｓ仍具３．９４倍能量阈值的安全范围。提示具有较大范围可程控电压和脉宽输出的ＤＤＤＲ起搏器配用低阈值激素电极可延长起搏器寿命，这也将是今后起搏系统设计的方向。

Programming and Longevity of DDDR Pacemaker

The longevity of physiological and safe pacing was evaluated in 21 patients implanted with a DDDR pacemaker of advanced technology. No dislodgement of lead was observed during a follow-up of 6～54(average 26 ) months.The chronic energy threshold in 20 steroid leads was 0.44 ± 0.51μJ and was significantly lower than in 15 screw-in leads(1.89±1.98μJ). For an adequate safety margin, the pacing outputs were programmed to 3 times the chronic energy threshold and even a 1.6 V,0.3ms pacing output which offered a 3.94 times safety margin.Our experience suggests that a DDDR pacemaker with a greater range of output programmability(voltage and pulse width) plus two low threshold steroid electrodes can prolong the unit life span and will be an objective of future technology design of pacing system.