起搏分析仪测定的兔离体心脏损伤电流与主动电极导线稳定性的关系  

Relation between active lead stability and current of injury in isolated rabbit heart measured by pacemaker analyzer

作　　者：沙来买提.沙力 刘恩焘 贾林 姚瑞明[1] 宿燕岗[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科上海市心血管病研究所,上海200032 [2]美敦力(上海)管理有限公司,上海201203

出　　处：《中国心脏起搏与心电生理杂志》2011年第3期241-244,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨损伤电流(COI)与主动起搏电极导线稳定性的关系,为临床上判断起搏电极导线固定的可靠性提供依据。方法 Langendorff法灌流离体兔心,应用起搏分析仪采集并记录电极接触、半旋入及全旋入心内膜时产生的腔内心电图,观察COI变化特征,比较三者的COI持续时间及大小,分析COI与电极固定牢靠度的相关性。结果螺旋电极COI大小,即R波起始后80 ms时的ST段振幅(ST80ms)、ST80ms/R及ICEG时程随时间的延长而逐渐减小(P<0.01)。全旋入电极COI持续时间为30.05±11.38 min,半旋入电极持续5.49±2.41 min,接触电极则在1.04±0.47 min内迅速消失(P<0.01)。全旋入电极在大部分时点产生的COI最大,接触电极最小,半旋入电极介于二者之间(P<0.001)。COI大小与水平相匀速牵拉导线至脱离心内膜所需拉力呈正相关(n=24,r=0.762 5,P<0.001)。结论 COI大及持续时间长均提示电极固定良好。Objective To determine whether current of injury（COI） magnitude and time duration are related to activefixation lead stability. Methods Active-fixation lead was fixed to the myocardium of isolated rabbit heart in manners of contacting without screwing, half screwing and fully screwing, respectively. Langendorff isolated heart perfusion was applied to enable constant intracardiac electrogram acquisition using pacing system analyzer （ Medtronic, Model 2290）. Both magnitude and time course of COI were measured manually to study the COI development. CO1 parameters related to three levels of lead stability were compared. Stability of half and fully screwing active leads was detected applying a digital terhsiometer after COI measurement. Correlation of COl magnitude and lead stability was studied. Results COl magnitude including ST80ms, ST80ms/R and ICEG duration decreased notably with time （ P 〈0. 001 ）. Fully screwed lead developed COI that lasted 30. 05 ± 11.38 min, and the COl time course of half screwed lead was 5.49 ± 2.41 min, while those of contacted lead without screwing dropped rapidly within 1.04 ± 0.47 min （P 〈 0.001 ）. Furthermore, fully screwed lead showed the biggest COI magnitude followed by half screwed lead, and the lead without screwing developed the smallest COI（ P 〈 0. 001 ）. There was a significant correlation between COl magnitude and active lead stability （ n = 24, r = 0. 7625, P 〈 0. 001 ）. Conclusions The adequate magnitude as well as long time course of COI promise good stability of active-fixation lead.

关 键 词：心血管病学 损伤电流 主动电极 兔离体心脏 起搏分析仪 

分 类 号：R318.11[医药卫生—生物医学工程]