除颤电极放置于右室流出道的可行性研究  

The comparative study of the efficacy and stability of defibrillation leads implanted in the right ventricular outflow tract

作　　者：于波[1] 靳艳[1] 程颖[1] 庞雪峰[1] 赵卫华[1] 齐国先[1] 

机构地区：[1]中国医科大学附属第一医院心内科,辽宁沈阳110001

出　　处：《中国心脏起搏与心电生理杂志》2010年第1期21-23,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的比较于右室流出道(RVOT)和右室心尖部(RVA)植入除颤电极的阈值、安全性和疗效的差异。方法按时间先后顺序选取符合入选条件的患者共19例,将除颤电极导线放置于RVA(n=11)或RVOT(n=8),采用双相查找的方法进行除颤阈值的测试。术后6个月随访,对导线的相关参数进行测试,对埋藏式心脏转复除颤器(ICD)记录的相关数据进行统计分析。结果RVA的除颤阈值和RVOT相比,差异无显著性(中位数:15Jvs17.5J,P=0.48);在ICD植入时,两个部位的起搏阻抗、R波振幅、起搏阈值的比较,差异亦无显著性;RVA和RV-OT不恰当识别及治疗事件的发生率无显著差异(4/11vs1/8,P=0.267)。结论RVOT的除颤和起搏效率与RVA相似。Objective To compare the defibrillation thresholds （ DFT）, safety and therapeutic efficacy of implantable cardioverter defibrillator between the right ventricular outflow tract （RVOT） and right ventricular apex （ RVA ）. Method According the time order, 19 patients who were enrolled in this trail underwent defibrillation threshold testing in the RVA or RVOT by using a binary search algorithm. After a follow-up of 6 months, relative parameters were tested and relative da- ta which was stored in implantable cardioverter defibrillator were analyzed with statistical analysis. Result The difference of DFT in leads placed in the RVOT and RVA was not Statistically significant （median： 15 J vs 17.5 J, P =0.48）. And, at time of device implantation, pacing impedance, R wave amplitude, pacing threshold were all comparable in the RVOT and RVA. The difference of the incidence of inappropriate detections and therapies was not also statistically significant （4/11 vs 1/8, P = 0. 267 ）. Conclusion The efficiency of defibrillation and pacing in the RVOT and RVA are similar.

关 键 词：心血管病学 埋藏式心脏转复除颤器 除颤阈值 右室流出道 

分 类 号：R318.11[医药卫生—生物医学工程]