不同永久起搏电极植入右心室心尖部的损伤电流变化  

Current injury of different permanent leads in right ventricular apical pacing

作　　者：杨军[1] 曹佳宁[1] 陈英[1] 金艳[1] 黄强[1] 徐欣[1] 杨承健[1] 

机构地区：[1]无锡市第二人民医院心内科,江苏无锡214002

出　　处：《心脏杂志》2016年第6期683-685,共3页Chinese Heart Journal

摘　　要：目的探讨不同永久起搏电极植入右心室心尖部后损伤电流(current of injury,COI)的变化特点。方法入选144例右心室心尖部植入永久起搏电极患者,分为被动电极组及主动电极组。测定电极固定后0、5和10 min的COI及常规起搏参数,分析COI变化特点。结果被动电极固定后0、5和10 min分别测定COI值均明显小于主动电极固定后测定的COI值(P<0.01)。两种电极固定后COI随时间均显著逐步下降(P<0.01),被动电极固定后COI值下降幅度明显大于主动电极(P<0.01)。被动电极固定后10 min内后5 min COI下降幅度大于前5 min下降幅度(P<0.01),主动电极固定10 min内COI值前后5 min下降幅度未见差异。术后3例患者电极脱位,其COI均<5.0 m V。结论右心室心尖部植入被动电极产生的COI明显小于主动电极,两种电极产生的COI均随时间逐步减小,被动电极产生的COI下降速度较快。AIM To investigate characteristics of current injury （COI） of different permanent leads in fight ventrieular apical pacing. METHODS One hundred and forty-four patients were divided into passive fixed lead group and active fixed lead group. Subjects were implanted with permanent pacing lead in fight ventricular apical. We determined COI and conventional pacing parameters at 0, 5 and 10 rain after lead fixed and the characteristics of COI were analyzed. RESULTS In the 146 patients, COI could not be measured accurately in two cases due to the large amplitude of intracardiac electrogram （ICEG）. COI gradually reduced after lead fixed in the remaining 144 cases. COI at 0, 5 and 10 rain after passive fixed lead was significantly lower than after active fixed lead （ P 〈 0. 01 ）. The decline of COI of passive fixed lead was significantly greater than active fixed lead （P 〈 0. 01 ） and COl of three cases with postoperative dislocated lead was 〈 5.0 inV. CONCLUSION COI of passive fixed lead is significantly smaller and decreases faster than active fixed lead in fight ventricular apical pacing. COI produced by both passive fixed lead and active fixed lead will decrease gradually after lead fixed.

关 键 词：被动电极 主动电极 损伤电流 右心室起搏 

分 类 号：R541[医药卫生—心血管疾病] R318.1[医药卫生—内科学]