主动固定电极在右心室不同部位起搏损伤电流变化  

Changes of current of injury after active fixation lead in different sites of right ventricular pacing

作　　者：杨军[1] 金艳[1] 陈英[1] 黄强[1] 徐欣[1] 曹佳宁[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》2017年第4期452-454,459,共4页Chinese Heart Journal

摘　　要：目的探讨主动固定电极植入右心室心尖部及中位间隔部后损伤电流(current of injury,COI)的变化特点。方法入选88例右心室植入主动固定电极患者,分为右心室心尖组及中位间隔组。测定电极螺旋旋出0、5、10 min的COI及常规起搏参数,分析COI变化特点及相关关系。结果 88例患者中有2例因心腔内电图(intracardiac electrogram,ICEG)振幅过大,其产生的COI无法准确测量。剩余86例患者测定的COI在主动固定电极螺旋旋出后逐步降低,5 min测定COI与0 min相比下降[(6.6±1.5)mV vs.(7.6±1.7)mV,P<0.05],10 min测定COI与5 min相比显著下降[(5.5±1.5)mV vs.(6.6±1.5)mV,P<0.05];螺旋旋出10 min后较0 min显著降低(P<0.01)。右心室主动固定电极测定的COI在心尖组及中位间隔组的差异无统计学意义。Pearson相关分析发现,0 min测定COI与起搏阈值之间呈负相关,相关系数(r)=-0.497,P<0.01。术后2例患者电极脱位,其COI均<5.0 mV。结论右心室主动固定电极螺旋旋出后COI值逐步降低,心尖组与中位间隔组COI的差异无统计学意义。0 min测定COI与起搏阈值之间呈负相关。AIM To investigate changes of current of injury （CO1） after active fixation lead in apex and median septum of right ventricular pacing. METHODS Eighty-eight patients with active fixation lead implanted in the right ventricle were divided into right ventricular apex group and median septum group. We determined COI at 0 min, 5 min and 10 min after lead fixation and conventional pacing parameters, and analyzed the correlation between COI and conventional pacing parameters. RESULTS In our 88 patients, COI could not be accurately measured in 2 patients due to the large amplitude of intraeardiac electrogram （ICEG）. In the remaining 86 cases, COI gradually reduced with the passage of time after lead fixation. COI was determined at 5 min after lead fixation decreased compared with that was deter- mined at 0 rain [ （6.6 ± 1.5） mV vs. （7.6 ± 1.7） mV, P 〈0. 05], COI at 10 rain decreased compared with that at5 min [（5.5±1.5） mV vs. （6.6±1.5） mV, P〈0.05], and COI was determined at 10min decreased significantly compared with that at 0 rain （P 〈0. 01 ）. But no statistical difference was found in COI of right ventricular active fixation lead between apex group and median interval group （ P 〉 0.05 ）. Pearson correlation analysis showed an inverse correlation between COI measured at 0 min and the pacing threshold （correlation coefficient： -0. 497, P 〈 0.01 ）. COI of the 2 patients with postopera- tively dislocated lead was less than 5.0 mV. CONCLUSION COI of rieht ventricular active fixationlead gradually reduces with the passage of time found between implantation in apex and median with the pacing threshold. after lead fixation and no statistical difference septum. COI measured at 0 min is inversely has been correlated

关 键 词：主动固定电极 右心室起搏 损伤电流 

分 类 号：R541.7[医药卫生—心血管疾病]