埋藏式心脏起搏器置入术后电极阻抗的动态变化及其临床意义  

Dynamic change of lead impedance and its clinical significance after cardiac pacemaker implantation

作　　者：陈小卫 王景峰[2] 张燕[2] 吴铿 莫振兆 

机构地区：[1]广东医学附属医院心内科,湛江市524000 [2]中山大学附属第二医院心内科,510120

出　　处：《岭南心血管病杂志》2004年第4期271-273,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的　观察埋藏式心脏起搏器置入术后起搏电极阻抗的动态变化规律 ,并探讨其机制及临床意义。方法　对 2 0 0 3年 4月至 2 0 0 3年 10月期间在我院接受埋藏式心脏起搏治疗的 33例患者分别于术中、术后 1w、2w、1个月、2个月、3个月和 6个月测定电极阻抗 ,同时随访起搏器功能状态。结果　 19条MedtronicCAPTURE SP(MCSP)系列心房激素电极阻抗术后均较术中明显降低 ,且差异具有显著性(P <0 0 1) ,术后 1w至 6个月无明显变化 ;2 4条MCSP系列心室激素电极阻抗亦表现出同样的变化趋势。 9条BIOTRONIKSYNOXSX(BSSX)系列高阻抗非激素心室电极阻抗术后亦均较术中明显降低 (P <0 0 1) ,术后 2w最低 ,其与术后 1、2和 3个月比较具有显著性差异 (P <0 0 5 )。所有患者起搏器起搏、感知功能均正常。结论　埋藏式心脏起搏器置入术后电极阻抗于 1w时开始明显降低 ,此后 6个月激素电极阻抗保持稳定 ,而非激素电极在正常范围内出现较大波动 ,但并不影响起搏器正常工作。Objectives To observe the dynamic change of lead impedance after cardiac pacemaker implantation and explore its mechanism and clinical significance. Methods 33 patients with 49 pieces of pacing leads were involved in the observation and the lead impedance was measured during implantation, 1 week, 2 weeks, 1 month, 2 months, 3 months and 6 months postimplantation respectively. Meanwhile the pacemaker function was followed up. Results For 16 MCSP steroid-eluting atrial pacing lead, the impedance decreased significantly since 1 week postimplantation (P<0.01) and remained stable within 6 months, and it was just the same for 24 MCSP steroid-eluting ventricular leads. For 9 BSSX high-impedance, nonsteroid-eluting ventricular pacing lead, the impedance also decreased significantly since 1 week postimplantation (P<0.01) and to its minimum in 2 weeks which was significantly different from the value measured in 1, 2 and 3 months after implantation (P<0.05). All of the pacemakers functioned well during the follow-up. Conclusions The lead impedance decreased significantly since 1 week postimplantation and remained stable for steroid-eluting lead, but it may change obviously within normal range for nonsteroid-eluting lead during the following 6 months while the pacemaker function was not affected.

关 键 词：埋藏式心脏起搏器置入术 电极阻抗 测定 心脏病 

分 类 号：R654.2[医药卫生—外科学]