主动固定电极导线的应用研究  

The Practical Research of Feasibility and Safety of Active Fixation Electrodes

作　　者：芦婷[1] 李学文[2] 王雄[2] 刘向东[2] 赵太生[2] 王群[2] 吴萍[2] 吕吉元[2] 

机构地区：[1]山西省稷山县人民医院 [2]山西医科大学第一医院

出　　处：《中西医结合心脑血管病杂志》2008年第2期137-139,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探索主动固定电极导线行心脏起搏临床应用的可行性与安全性。方法将需要安置永久性心脏起搏器的60例病人,随机分为两组,30例用主动固定电极行右心房、右心室间隔部起搏(主动电极组),30例用被动固定电极行右房心耳部、右室心尖部起搏(被动电极组),记录两组在术中、术后的各项参数并进行比较。结果两组均顺利完成手术,未出现严重并发症。两组曝光时间无明显差异。主动电极置入后5min后可达到理想阈值。两组起搏阈值、R波波幅置入时比较无明显差异。主动电极组置入时起搏阻抗、P波波幅较被动电极组低,但7d后,两组无明显差异。所有病人均在术后7d和出院后1个月、3个月进行随访。术后7d、1个月时两组起搏阈值均升高,相反,阻抗降低。3个月时均恢复至置入时水平,两组比较无明显差异。起搏心电图比较,主动电极组的QRS、P波宽度均较被动电极组窄,差异有统计学意义(P<0.05)。被动电极组有1例发生电极脱位,主动电极组均未发生电极脱位。结论使用主动固定电极行心脏起搏是可行的、安全的。Objective To explore the feasibility and safety of active fixation electrodes. Methods Sixty patients （pts） implanted with pacemaker were randomly divided into two groups： Active electrode group （right atrial and right ventricular septal pacing with the active fixation electrodes, n = 30） and passive electrode group （right atrial appendage and the right ventricular apical pacing with passive fixation electrodes, n =30）. The parameters in two groups were recorded and compared pre - and post - operation. Results Operation in two groups came off smoothly and there were no complications. There were no differences between the active and passive electrode in exposure time. At 5min after active fixation electrode was planted, the pacing threshold dropped dramatically compared with the one done immediately. There were no differences in pacing threshold and R - wave sensing between two groups. The pacing impedance and P- wave sensing in active electrode group were lower than that in the passive electrode group, but there were no differences between the two groups after 7 days. The pts were followed up at 7 days, 1 month and 3 months after operation. At 7 day and 1 month, the thresholds in two groups were increased and the impedances were decreased. At 3 month, the thresholds and impedances were recovered but there were no differences between the two groups. The widths of the QRS and P waves in the active electrode group were narrower than that in the passive electrode electrode group. There was 1 case with wire dislocation in passive electrode group. Conclusion The active fixation electrodes were feasibility and safety for pacemaker implantation.

关 键 词：主动固定电极 心脏起搏 心电图 

分 类 号：R541[医药卫生—心血管疾病]