具有心房自动阈值管理功能起搏器在病窦综合征患者中的临床应用

目的观察具有心房自动阈值管理功能起搏器在病窦综合征患者中的临床应用情况。方法18例病窦综合征患者置人具有心房自动阈值管理功能起搏器（Enpulse系列7例，Sensial系列5例，Adapta系列6例），于置入时，置入后1周、1个月、6个月采用起搏分析仪及体外起搏器程控仪测定心房起搏阈值和阻抗，利用ACM进行术后阈值和阻抗的动态观察。结果测定的心房阈值与ACM测定值差异无统计学意义；心房起搏阈值均〈1．0V，心房起搏阈值于置入1个月后有下降趋势，阻抗未见明显变化。预期使用寿命6个月时测定为（8．7±2．4）年。结论病窦综合征患者置入具有心房自动阈值管理功能的起搏器心房起搏安全有效，起搏器预期使用寿命延长。

The clinical application of pacemakers with function of atrial auto capture management in patients with sick sinus syndrome

Objective To assess the efficacy and safety of pacemakers with the function of atrial automatic capture management （ACM） in patients with sick sinus syndrome. Methods Eighteen patients with sick sinus syndrome were implanted with atrial automatic capture management pacemaker, including 5 Sensial, 7 Enpulse, 6 Adapta. Atrial pacing thresholds and lead impedance were obtained by pacing system analyzer and pacing programmer, and were compared with that tested by ACM at once, 1 week, 1 month and 6 months follow up after implantation. Results There was no significant statistical difference in thresholds and impedances between tested by pacing system analyzer and ACM. The pacing threshold of atrium were less than 1.0 V. The threshold of atrium started to descend at 1 month after operation, but the impedance had not redundant variance. The expected service life of pacemakers were observed for （8.7±2.4）years at 6 months after implantation. Conclusion The pacemakers with atrial automatic capture management system are effective and safe in patients with sick sinus syndrome, and have a longer expected service life.