采用螺旋电极导线行右室流出道间隔部起搏的经验

目的介绍主动固定螺旋电极在右室流出道间隔部起搏中的应用经验。方法86例起搏适应证患者随机分成两组,一组42例采用主动固定螺旋电极行右室流出道室间隔起搏(简称主动电极组),另一组44例应用被动固定电极行右室心尖起搏(简称被动电极组),观察两组有关手术指标及主动电极组的起搏参数。结果主动电极组电极操作时间长于被动电极组(18.4±7.7 min vs 16.6±6.5 min,P<0.05),起搏QRS波时限则明显短于被动电极组(0.138±0.046 s vs 0.162±0.020 s,P<0.01);主动固定螺旋电极植入后起搏阈值达高峰,15 min后即降至稳定水平(0.78±0.26 Vvs 0.54±0.27 V,P<0.05);主动电极组1例发生电极脱位。结论主动固定螺旋电极在右室流出道室间隔起搏中是可行的、安全的,植入方法是关键。

Experience in the application of active fixation leads in patients with right ventricular septum pacing

Objective To introduce experience in the application of active fixation leads in right ventricular septum pacing. Methods Eighty-six patients were divided into two groups randomly. 42 patients underwent the fight ventricular septum pacing with active fixation leads（ active lead group）, the others underwent the fight apical pacing with passive fixation leads（ passive lead group）. The characteristic of operation in two groups were observed and the parameters of active leads were also recorded. Results Active lead group took more time to plant leads （ 18.4 ±7.7 min vs 16.6 ±6.5 min, P 〈0.05）. The width of QRS complexes in active lead group was narrower than that in passive lead group（0. 138 ±0. 046 s vs 0. 162 ± 0. 020 s, P 〈 0.01 ）. The pacing threshold dropped to stable level dramatically at 15 minutes after the active fixation lead planted compared with the value at begining of lead plant immediately（0.78 ± 0.26V vs 0.54 ± 0.27V, P 〈 0. 05 ）. 1 case of wire dislocation happened in the active lead group. Conclusion The usage of active fixation leads in patients with ventricular septum pacing is feasible and safe. The planting method is key to operation. Chinese Journal of Cardiac Pacing and Electrophysiology, 2009,23 （ 5 ） ：408 - 409 ]