置入双腔起搏心脏复律除颤器及经腋静脉送入心内电极的初步临床体会  

Preliminary clinical results with implantation of the dual chamber pacemaker defibrillator and theplacement of endocardial leads via axillary vein

作　　者：杨杰孚[1] AnnePowell MichaelDavis 

机构地区：[1]北京医院心内科,100730 [2]澳大利亚帕斯皇家医院心内科,100730

出　　处：《中华心血管病杂志》1999年第1期42-44,共3页Chinese Journal of Cardiology

摘　　要：目的初步评价新型双脏起搏心脏复律除颤器抗室性心动过速／心室颤动（室速／室颤）及心动过缓起搏的临床效果，了解经腋静脉送人心房及心室电极的安全性及有效性。方法７例室速及（或）室颤同时伴有心动过缓患者接受了双腔起搏心脏复律除颤器治疗，其中冠心病５例、扩张性心肌病２例。心房及心室电极均在Ｘ线透视、静脉注人造影剂指导下，直接穿刺腋静脉，从该静脉送人。结果脉冲发生器埋在左上胸皮下５例，埋在胸大肌与胸小肌之间２例。仪器对所有室速／室颤均能及时识别并成功治疗，同时提供有效的房室顺序起搏功能。所有心内电极均成功地经腋静脉送人，无并发症。结论双腔起搏心脏复律除颤器不但能有效地治疗严重室性心律失常，而且提供可靠的房室顺序性起搏功能。经腋静脉送入电极安全、可靠。Objective To assess priliminarily clinical efficacy with implantation of dual chamberpacemaker defibrillator and to evaluate the safety and effectiveness of placement of endocardial leads via the axillaryvein. Methods Seven patients with ventricular tachycardia and/or ventricular fibrillation (VT/VF), associatedwith bradycardia received implantation of dual chamber pacemaker defibrillator. The underlying diseases werecoronaly artery disease in 5 patients and dilated cardiomyopathy in 2 patients. The atrial and ventricular leads wereintroduced via the axillary vein under venographic guidence. Results The dual chamber pacemaker defibrillators were successfully implanted in the left chest subcutaneous pocket in 5 patients and left pectoral muscular pocket in2. All the VT/VF occurring either induciblely during procedure or spontanuously during follow-up were detectedpromptly and treated successfully. Both pacing and sensing functions were satisfactory. The endocardial leadsrequired were successfully introduced via the axillary vein. Conclusion Dual chamber pacemaker defibrillator canprovide reliable anti-VT/VF and dual chamber pacing function. Placement of endocardial leads via the axillary veinunder venographic guidance is safe and effective.

关 键 词：除颤器 植入型 心脏起搏 心律失常 腋静脉 

分 类 号：R654.2[医药卫生—外科学]