固定螺旋主动起搏导线的临床应用  

Clinical application of the FINELINE^TM Ⅱ EZ fixed spiral active pacing lead

作　　者：李燕萍[1] 郝应禄[1] 廖德荣[1] 蔡子奇 杨玲[1] 钱宝堂[1] 

机构地区：[1]昆明医科大学第六附属医院 云南省玉溪市人民医院心内科,653100

出　　处：《中华心律失常学杂志》2017年第1期74-76,92,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：云南省运用基础面上项目（2013FZ258）

摘　　要：目的 报道本中心70例在双腔起搏器植入术中应用固定螺旋主动起搏导线的体会,介绍FINELINETM Ⅱ EZ主动起搏导线的操作要领,探讨其安全性和临床价值.方法 对2014年1月至2016年10月在云南省玉溪市人民医院心导管室植入双腔起搏器（心房、心室均采用FINELINETMII EZ主动导线）的患者70例,分析植入导线的X线曝光时间及射线量、术中起搏参数（起搏阈值、感知灵敏度、起搏阻抗）、术者重新选择导线植入位置的情况,以及术后心电图QRS时限变化,并在术后7 d、1、3个月随访统计导线起搏参数和导线脱位、穿孔、心包积液、感染等并发症情况.结果 FINELINETMII EZ主动导线心房、心室两条导线植入术中头端甘露醇胶囊帽溶解后即可旋入固定;导线头端涂有独特的氧化铱涂层钛,使导线旋入心肌后5 min内起搏阈值明显降低.接受植入患者术后均卧床24 h,术后导线相关的并发症为0.结论 固定螺旋主动固定导线旋入心肌后起搏阈值明显降低需要数分钟,通常情况下可常规于旋入5 min后再评估是否需要调整导线位置.植入时间X线曝光时间短.固定螺旋主动固定导线在应用过程中是安全有效的.Objective To investigate the implantation time,X-ray exposure dose,pacing parameter changes in different stages during and after the implantation,at the 7^th day,1^St month,and 3^rd month,and evaluate the safety and efficiency of the active-fixation pacing lead（FINELINE^TM Ⅱ EZ）.Methods Seventy patients with Brady-arrhythmias and accepted dual-chamber pacing therapy were included in the 6^th Affiliated Hospital of Kunming Medical University from January 2014 to October 2016.FINELINE^TM Ⅱ EZ leads were implanted through the left or right subclavicular vein and fixed in the right ventricular outflow tract.The pacing parameters,including pacing threshold,R wave amplitude and the electrode impedance,were tested at the moment after screwing the leads and 5 minutes later,immediately after the procedure and 3 months later.Complications such as electrode dislocation,electrodes perforation,intravenous associated thrombosis and pocket infection were also observed in all patients.Results Pacing threshold was a bit high at the moment after screwing the leads,and decreased 5 minutes later.Further decreasing was observed immediately after procedure,and maintained stable after 3 months.Normal R wave amplitude found at immediately after the procedure and 3 months later.Conclusion For the FINELINETM Ⅱ EZ,the pacing threshold reduced significantly 5 minutes later compared to the moment after screwed.So it is appropriate to test the pacing threshold 5 minutes after screwing the lead and to determine whether to adjust the electrode position or not.FINELINETM Ⅱ EZ,the active-fixation pacing lead,is safe and efficient in the clinical application.

关 键 词：起搏器 主动固定导线 固定螺旋 

分 类 号：R541.7[医药卫生—心血管疾病]