自动夺获起搏器的临床应用  

Clinical Use of Pacemakers with Autocapture

作　　者：张琪[1] 章隆泉[1] 周哲慧[1] 刘辉[1] 刘建平[1] 王彬尧[1] 

机构地区：[1]上海第二医科大学仁济医院心内科,上海200001

出　　处：《上海第二医科大学学报》2000年第2期132-134,共3页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：０的观察８例具有自动夺获功能的单心脏起搏器的各种参数特点及程控功能。方法８例患者，植入Ｒｅｇｅｎｃｙ ＳＣ+型ＶＶＩ起搏器６例，Ｒｅｇｅｎｃｙ ＳＲ+型ＶＶＩＲ起搏器２例，随访１～１８个月，检查动态。ｂ电图并通过程控观察起搏阈值、ＥＲ值及极化电位的变化。结果８例患者起搏功能良好，６例ＥＲ值及极化电位良好而打开自动夺获功能，起搏阈值稳定在０．９～１.5ｍＶ间，可见后备脉冲多为融合波触发。１例因ＥＲ值较低（１．5ｍＶ），另１例ＥＲ值偏低（３．３ｍＶ）且极化电位大于ＥＲ的６０％，未能打开自动夺获功能。结论 具有自动夺获功能的起搏器安全可靠，但有赖于良好的ＥＲ值、极化电位和感知安全度。ＥＲ值可能与心肌病变有关。调整ＥＲ感知灵敏度可能获得较好的ＥＲ信号及感知安全度。Objective This study is to detect the characteristics of each parameter and programmed control function of the single chamber pacemaker with autocapture capability. Methods Autocapture pacemakers were implanted in & patients, 6 of Regency SC+VVI type and 2 Regency SR+VVIR type. The pacing threshold, ER signal and polarized potentials were checked repeatedly within 1 to 18 months. Results Pacing function was normal in & patients. Autocapture function was turned on in 6 patients with normal ER signal and polarized potentials. The pacing threshold was 0.9~1.5mV. The backup pulse was delivered by pseudo fusion beats. Autocapture function could not be initiated, because of a lower ER signal in one patient and polarized potential 60% higher than ER in another. conclusion Pacemakers with Autocapture function are safe and reliable, but their function depends on suitable ER signal, polarized potentials and safety margin. ER signal change may be associated with myocardial diseases. More appropriate ER signal and polarized potentials may be reached by the adjustment of ER sensitivity of the pacemaker.

关 键 词：自动夺获功能 心脏起搏器 临床应用 

分 类 号：R654.2[医药卫生—外科学]