经永存左上腔静脉植入起搏电极导线的方法探讨

目的初步探讨经永存左上腔静脉植入起搏电极导线的方法。方法 4例永存左上腔静脉合并右上腔静脉缺如的缓慢性心律失常患者,经左上腔静脉植入右心房和右心室起搏电极导线,心房起搏电极固定于右心耳(4例),心室起搏电极分别固定至右心室间隔部(2例)或心尖部(2例)。术后当天、术后3个月及1年分别测试起搏电极参数。结果 4例患者均成功放置右心房(心耳处)和右心室(间隔部或心尖部)起搏电极导线,随访1年,起搏电极参数良好。结论经左上腔静脉植入起搏电极导线具有一定的挑战性,但通过适当的导丝塑形和操作,通常可将导线固定于右心房心耳部和右心室间隔部或心尖部。

An investigating of methods for implantation of pacing lead through persistent left superior vena ;cava

Objective To explore the methods for implantation of pacing lead through persistent left superior vena cava. Methods Four patients who need implant pacemakers for suffering from bradyarrhythmias were found to have persistent left superior vena cava and absent right superior vena cava. Through the left superior vena cava, the atrial pacing leads of four patients were fixed in the right atrial appendage, and the ventricular pacing leads of two patients were screwed into the right ventricular septum and another two were placed at the right ventricular apex. Pacing leads parameters were measured on 1 day, 3 months and 1 year after the operation. Results Four patients were successfully implanted the atrial and ventricular pacing leads. And the parameters of both atrial and ventricular pacing leads were satisfactory. Conclusion By means of appropriate stylet shaping and careful operation, the atrial and ventricular pacing leads may be screwed into the right atrial appendage and right ventricular septum or apex through the persistent left superior vena cava.