主动电极在右室流出道间隔部起搏的临床应用  

Application of active-fixation lead in patients with right ventricular outflow tract septum pacing

作　　者：崔俊友[1] 张华[1] 殷泉忠[1] 易桂斌[1] 陆叶[1] 王东升[1] 徐伟 

机构地区：[1]江阴市人民医院心内科,江苏江阴214400 [2]南京市鼓楼医院心内科,江苏南京210016

出　　处：《南京医科大学学报（自然科学版）》2009年第8期1124-1127,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：2008年无锡市科技局社会发展项目资助(课题立项编号:CSZ00805)

摘　　要：目的:观察主动电极在右室流出道间隔部起搏安全性和可行性。方法:80例需起搏器植入的患者,随机入组,采用VVI或DDD起搏模式,右室流出道间隔部起搏(RVOTS组)和右心室心尖部起搏(RVA组)各40例,观察两组在术中及术后的各项参数以及起搏心电图的QRS宽度。结果:两组患者均顺利完成手术,两组各1例术后发生电极脱位。全部手术无严重并发症出现。RVOTS组手术X线曝光时间明显延长(19.8±6.4 vs 10.3±4.8,P<0.01);术中心室的起搏阈值RVOTS组高于RVA组(0.61±0.23 vs 0.48±0.17,P<0.05),但术后1个月及3个月无统计学差异,两组间阻抗、感知在术中及术后无统计学差异,起搏心电图QRS波宽度无统计学差异。结论:主动电极在右室流出道间隔部起搏是安全和可行的。Objective：To investigate the safty and feasibility of active-fixation lead in patients with right ventricular outflow tract septum （RVOTS）pacing. Methods：Eighty patients were divided into two groups randomly. One group underwent the right ventricular outflow tract septum（RVOTS）with the active-fixation lead. The other group underwent the right ventricular apex（RVA）pacing with the passive-fixation lead. The parameters in and after operation of two groups were recorded and compared accordingly. Results：Operations went smoothly without complications in two groups. The active-fixation lead group had one case of wire dislocation, while the passivefixation lead group also had one. Terms of X ray exposure time in active group were significantly longer than those in passive group （19.8 ± 6.4 vs 10.3 ± 4.8,P 〈 0. 01）. After implantation of active electrode, the pacing thresholds were higher than those underwent passive electrode（0.61±0.23 vs 0.48 ± 0.17,P 〈 0. 05）. However,there was no difference between the two groups in pacing thresholds at one and three month point during follow-up. Pacing impedance and R-wave sensing between two groups had no significance. Meanwhile, there was no difference in the QRS duration between two groups. Conclusion：It is safe and feasible to pace in RVOTS with active electrode.

关 键 词：右室流出道间隔部 心脏起搏 主动电极 

分 类 号：R540.4[医药卫生—心血管疾病]