儿童先天性心脏病矫治术后三度房室阻滞起搏器植入的随访

目的探讨儿童先天性心脏病矫治术后并发三度房室阻滞植入心脏永久起搏器后的相关问题及心功能状况。方法对12例先天性心脏病矫治术后持续性三度房室阻滞者植入心脏永久起搏器，并进行术后随访，随访0．5～7．8年，复查心电图，并对起搏参数、起搏阈值进行检测；必要时行X线胸片、超声心动图、24h动态心电图检查。结果植入术后与心动过缓有关的临床症状消失，心电图、X线胸片、超声心动图检查结果较术前改善，患儿发育良好，起搏器起搏和感知功能良好，术后3个月内起搏阈值有明显增高，3个月后起搏阈值无明显差异，1例术后1．5年恢复窦性心律。无1例因起搏电极导线预留不够发生起搏电极导线脱位。1例患儿术后3个月发生起搏器囊袋磨破、起搏器外露，继发感染。1例患儿术后1年因青霉素过敏致死。结论儿童植入心脏永久起搏器是安全有效的。

Pacemaker implantation after congenital heart disease surgery in children with complete atrioventricular block: a follow-up study

Objective To evaluate heart function and related problems in children with pacemaker im plantation because of third artrioventricular block (Ⅲ° AVB) post-congenital heart disease surgery. Meth ods Pacemaker implantation was carried out in 12 children with IE ° AVB after repair of congenital heart dis ease. Electrocardiography, chest X-ray, echocardiography and pacemaker parameter were obtained and analyzed in 6 months to 7. 8 years follow-up visits. Results The bradycardia disappeared and clinical symptoms im proved. All the children grew up healthily. During the first 3 months after implantation, the pacing-threshold was increased obviously. The sinus rhythm recovered in 1 case 1.5 years later. Pacemaker erosion happened and lead to infection in 1 case 3 months later. Allergy to penicillin resulted in death in 1 case. Conclusion Pace maker implantation is safe and efficient in children with complete atrioventricular block post-congenital heart disease surgery.