高阻抗电极导线在永久心脏起搏中的应用价值  

Value of high impedance leads in permanent cardiac pacing

作　　者：马小川[1] 王建清[1] 张全发[2] 

机构地区：[1]延安大学附属医院心血管内科,陕西延安716000 [2]西安交通大学第一医院心血管内科,陕西西安710061

出　　处：《临床荟萃》2004年第13期739-741,共3页Clinical Focus

摘　　要：目的　探讨高阻抗电极在永久心脏起搏中使用的可操作性、安全性及实用意义。方法　 6例患者 ,心房、心室均使用高阻抗电极作为试验组。 2 4例患者使用普通激素电极作为对照组。术中测定心房、心室起搏阈电压和电极阻抗 ,组间进行t检验。术后 1周、1个月和 3个月对高阻抗电极组进行随访 ,测量电极阻抗和起搏阈电压的变化。结果　手术顺利 ,手术时间 (1.8± 0 .5 )小时。两组术中阈电压的差异无统计学意义 (P >0 .0 5 ) ,而电极阻抗有统计学意义差异 (P <0 .0 0 1)。试验组术后随访电极阻抗与阈电压均稳定 ,感知与起搏功能良好 ,无电极脱位、电极断裂、囊袋感染等并发症。结论　相对于普通激素电极 ,高阻抗电极的可操作性变化不大 ,对起搏阈值无不良影响 ,起搏的安全性同普通激素电极相当。高阻抗电极可提高电极阻抗 ,减少输出电流 ,降低能量消耗 。Objective To evaluate the handling characteristics, the reliability and effect of high impedance leads in permanent cardiac pacing. Methods Six patients included as experiment group were implanted with high impedance atrial and ventricular leads. Other 24 patients were implanted with traditional steroid-eluting leads as control group. The original values of lead impedance and pacing thresholds were tested and compared by t-test between groups. The patients with high impedance leads were followed up at 1 week,1 month and 3 months postimplant. Lead impedance, pacing thresholds were observed during follow-up. Results The implanting procedure took ( 1.8± 0.5) hours. The original voltage thresholds had no significant variety(P> 0.05),but the leads impedance had very significant variety between two groups(P< 0.001).No significant variety was observed in pacing impedance or thresholds during follow-up. No dislocation of the leads occurred in the period of follow-up. No infections were observed. Conclusion The surgical handling of high impedance leads is no more difficult than traditional steroid-eluting leads. The pacing thresholds are satisfactory. The leads display higher impedance values and lower current values. Thus high impedance lead appears to result in a clinically relevant extension of generator longevity.

关 键 词：心脏起搏 人工 电极 电阻抗 

分 类 号：R541.7[医药卫生—心血管疾病]