起搏器植入术中双极导线单、双极模式参数的比较  

Comparison of unipolar and bipolar modes′parameters of bipolar leads during pacemarker implantation procedure

作　　者：张旭东[1] 李京波[1] 刘铭雅[1] 潘晔生[1] 张庆勇[1] 黄冬[1] 

机构地区：[1]上海交通大学附属第六人民医院心血管内科,上海200233

出　　处：《中国心脏起搏与心电生理杂志》2011年第3期227-229,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的比较起搏器植入术中双极导线单、双极模式的参数。方法共入选117例患者,术中共植入78根心房双极导线和117根心室双极导线,以Medtronic 5318起搏分析仪测试起搏参数,固定脉宽为0.42 ms。结果术中双极导线单极模式与双极模式的起搏阈值无差异(P均>0.05);双极模式的P/R波振幅高于单极模式(P均<0.01);心房、心室双极模式的阻抗均大于单极模式(P均<0.05)。术后随访无1例有阈值异常增高,导线脱位或断裂发生。结论双极导线单、双极模式的起搏阈值无差异;双极模式的感知优于单极模式,而阻抗较单极模式高。Objective To compare the parameters of unipolar and bipolar modes of bipolar leads during pacemarker implantation procedure. Methods One hundred and seventeen patients were enrolled. Seventy-eight bipolar atrial leads and 117 bipolar ventrieular leads were implanted in all. Pacing threshold voltage, lead impedance and P/R amplitude of unipolar and bipolar modes were measured while pulse width was fixed at 0.42 ms by Medtronic 5318 pacing system analyzer during procedure. Results There were no significant difference in pacing thresholds between unipolar and bipolar modes during procedure （ all P 〉 0. 05 ）. P/R amplitude of bipolar modes were higher than those of unipolar modes （ all P 〈 0. 05 ）. There was a significantly higher impedance with bipolar modes （ all P 〈 0.05 ）. There were no abnormal increasing in pacing thresholds, lead dislodgment and fracture during the follow-up. Conclusions No significant difference in pacing thresholds between unipolar and bipolar modes of bipolar leads. Bipolar sensing is indeed superior to unipolar. Compared with unipolar mode, there is a significantly higher impedance with bipolar mode.

关 键 词：心血管病学 导线 单极模式 双极模式 阈值 P/R波振幅 阻抗 

分 类 号：R318.11[医药卫生—生物医学工程]