Zephyr5826起搏器心房自动阈值管理的临床观察  

The clinical observation of the atrial capture management in Zephyr5826 pacemaker

作　　者：司海龙[1] 林文华[1] 张峰[1] 王晓冬[1] 史宏岩[1] 宋振国[1] 刘菁晶[1] 任自文[1] 

机构地区：[1]天津医科大学心血管病临床学院泰达国际心血管病医院心内一科,天津300457

出　　处：《中国心脏起搏与心电生理杂志》2012年第3期215-217,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的动态观察Zephyr5826起搏器心房自动阈值管理(ACM)功能的开启情况、准确性及安全性。方法选取置入Zephyr5826起搏器患者68例,于置入术后第1,7天及1,2,3,6个月时随访程控,观察ACM功能的开启情况,手工测试心房起搏阈值并与ACM功能测定的值进行比较。结果 68例均完成随访。随访期内35例(51.50%)成功开启ACM功能,其中术后第1,7天及1,2,3个月时开启例数分别为14例(20.6%)、21例(30.9%)、26例(38.2%)、28例(41.2%)和32例(47.1%)。手工测试与ACM测试的心房阈值无差异。33例因起搏器自动测定心房刺激除极波(ER)过小不推荐开启ACM功能。随访期间心电图及动态心电图(Holter)均未见心房失夺获及感知不良。与普通电压和高电压起搏相比,自动阈值管理功能在心房输出方面分别节省50%,88%的能量消耗。结论 Zephyr5826起搏器ACM功能可以安全有效的应用低能量起搏心脏。部分患者术后因起搏器测定心房ER过小未能开启ACM功能,但在随访过程中ACM的开启比例逐渐升高。Objective To observe the effect of the atrial capture management （ACM） in Zephyr5826 pacemaker. Methods Sixty-eight patients were implanted Zephyr5826 pacemaker. The operation of ACM function was observed and the atrial thresholds tested manually were compared with that tested by ACM function at the time of 1 day,7 days, 1 month, 2 months,3 months and 6 months after implantation. Results Sixty-eight patients finished the follow-up. 14,21,26,28, 32 and 35 patients＇ function were turned on at the time of 1 day,7 days, 1 month,2 months,3 months and 6 months after im- plantation. The atrial thresholds tested by ACM function had no statistical significant difference with the thresholds tested manually. 33 patients＇ ACM function could not be turned on due to the insufficient atrial ER. The ECG and Holter monito- ring in all patients showed a normal pacing function without loss of capture. Conclusion To test the threshold and re- duce the energy output automatically by ACM function are effective and safe in Zephyr5826 pacemaker. The ACM function could not be turned on in several cases patients after implantation due to the insufficient atrial ER, but the percent age of ACM function turn-on increases gradually during the follow-up.

关 键 词：心血管病学 起搏器 起搏阈值 自动阈值测试 心房阈值管理 

分 类 号：R318.11[医药卫生—生物医学工程]