有自动夺获功能的双腔起搏器的临床随访  

Clinical follow-up of dual chamber pacemaker with ventricular autocapture function

作　　者：许静[1] 付乃宽[1] 吴尚勤[1] 孙姗[1] 信庭文[1] 王瑞莹[1] 

机构地区：[1]天津胸科医院心内科,300051

出　　处：《中华心律失常学杂志》2001年第3期148-150,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的 观察双腔心室自动阈值夺获起搏器长期的参数变化及安全性。方法 我院１９９９年１０月至２０００年６月住院植入具有心室自动阈值夺获功能的双腔起搏器２０例，观察术中、术后１周、２周、１个月、３个月及６个月后的心室起搏阈值、输出电压、ＥＲ振幅、阻抗、极化电位及自动工作方式转换功能。结果 术后早期心室起搏阈值、极化电位轻度升高，２周后趋于稳定，其余参数无明显变化，长期的心室起搏电压平均为（１．２６±０．３８）Ｖ。１５例术后即刻可以启动自动夺获功能，４例术后１周可启动自动夺获功能，随访期间功能正常，无起搏脱漏现象，且５例伴有阵发性心房颤动的患者，心房颤动时均可发生工作方式转换，未出现起搏器介入性心动过速。ｌ例肥厚梗阻性心肌病患者因术中及术后极化电位较高致自动夺获功能不能启动。结论 有自动夺获功能的双腔起搏系统耗能低，安全可靠，满足了患者的生理需要。但对有心内膜病变患者有待进一步观察。Objective To evaluate parameter changes and safety of dual chamber pacemaker with ventricular autocapture function. Methods Dual chamber pacemakers with ventricular autocapture function (Pacesetter Affinity DC 5230R) were implanted in 20 patients; Stimulation threshold, output amplitude, evoked response (ER), impedance and polarizing potential were measured during implantation procedure and 1st week, 2nd weeks, 4th weeks, 3rd months, 6th months after implantation. Results The mean ventricular pacing threshold and polarizing potential had mild rise early after implantion. Others had no marked change. Long-term output amplitude was (1.26 ± 0.38) V.Autocapture function was normal in 19 patients, standing failed in one with hypertyophic obstractive car- diomyopathy. Automatic mode switch (AMS)function was observed in 5 patients in response to paroxysmal atrial tachy- cardia or atrial fibrillation, no pacemaker mediated tachycardia happened. Conclusion The dual chamber pacemak- er with ventricular autocapture function is energy saving and safe but need more observation in patients with cardiop- myopathy.

关 键 词：双腔起搏器 自动压获功能 自动阈值 

分 类 号：R541.7[医药卫生—心血管疾病]