植入有自动夺获功能的起搏器临床观察  

Clinical evaluation of pacemakers with aotocapture function

作　　者：华伟[1] 王方正[1] 余培贞[1] 张奎俊[1] 王锦志[1] 马坚[1] 李一石[1] 孙瑞龙[1] 陈新[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院,100037

出　　处：《中华心律失常学杂志》1997年第2期88-90,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的:观察有自动夺获功能起搏器的自动起搏能量测定、能量输出和后备起博功能。方法:8例患者,男性6例,女性2例,平均年龄62.8岁,均值入了具有自动夺获功能的心室起搏器(RegencySC+,VVI)。此种起搏器在确认起搏丧失夺获后,自动发放一个高能量的后备脉沖,以确保起搏的安全性。患者植入起搏器后一周进行24小时动态心电图检查,以观察后备起搏功能,并通过体外程控的方法调出起搏器储存的阈值曲线观察其能量输出。结果:8例患者,动态心电图记录总起搏心搏为490 450个,后备脉冲为372次,占0.08%,后备脉冲中,融合波和伪融合波是导致其发放的主要原因,共有305个(82%)后备起搏脉冲是由(伪)融合波触发的。未见丧失夺获而无后备脉冲发放的情况。起搏器储存的一周输出能量曲线显示,起搏器阈值在植入后较为平稳,波动在0.6～1.2 V 之间,起搏器实际输出电压在0.9～1.5 V。结论:带有自动夺获功能的起搏器为患者提供了最大的安全性,并节省输出能量。Objective:The study is to observe the backup pulse delivery and evaluate the pacing safety of the autocapture pacing system.Methods:Pacemakers with autocapture function were implanted in 8 patients,male in 6 and female in 2,mean age of 62.8 years.The autocapture pacing alogrism is able to auto- matically confirm capture and adjust its output to 0.3 V above the actual prevailing pacing threshold.If the pacemaker did not confirm capture within 62.5 ms,a high energy backup pulse will be delivered.The Holter monitoring was performed one week after pacemaker implantation.Results:There were total 729 711 beats recorded in 8 patients in which 490 450 beats were paced beats.The backup pulse account for 0.08% paced stimuli.The main cause of the delivery of the backup pulses was(pseudo)fusion beats.There is no single event of loss of capture without a subsequent backup pulse was found.The output curve record- ed by pacemaker showed the pacemaker output varied from 0.9～1.5 V in one week after implantation, which is much lower than that of traditional pacing system.Conclusion:This study shows that auto- capture function reliably regulates the output of pacemaker according to the actual pacing threshold and the backup pulse provides the maximum safety of patient.

关 键 词：起搏器 自动夺获功能 植入 患者 临床观察 发放 VVI 24小时动态心电图 高能量 心室起搏 

分 类 号：R541[医药卫生—心血管疾病] R654.2[医药卫生—内科学]