植入型心律转复除颤器电风暴后除颤电极参数稳定性研究  

The stability of electrode parameters of defibrillation leads after ICD electrical storms

作　　者：许国卿[1] 于海波[1] 梁延春[1] 刘荣[1] 高阳[1] 徐白鸽[1] 武敏 焉晓蕾 王祖禄[1] XU Guo-qing;YU Hai-bo;LIANG Yan-chun;IU Rong;GAO Yang;XU Bai-ge;WU Min;YAN Xiao-lei;WANG Zu-lu(Department of Cardiology,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第10期1189-1191,共3页Clinical Journal of Medical Officers

基　　金：国家重点研发计划项目(2016YFC0900904);辽宁省自然科学基金(20180550901)

摘　　要：目的探讨植入型心律转复除颤器(ICD)植入患者发生电风暴后除颤电极参数的稳定性。方法回顾性分析自2010年1月至2016年12月于沈阳军区总医院行ICD手术且术后发生ICD电风暴的65例患者的随访资料,比较患者ICD电风暴前,电风暴后即刻、3个月、12个月的除颤电极参数(阈值、阻抗、R波振幅)的变化情况。结果发生ICD频繁放电后24 h内测量的即刻除颤电极的起搏阈值测定值较电风暴前有所升高,差异有统计学意义(P <0. 05); R波振幅测定值较电风暴前有所下降,但差异无统计学意义(P> 0. 05);阻抗测定值与电风暴前比较,无明显变化(P> 0. 05)。在电风暴后3、12个月,起搏阈值测定值较电风暴后即刻明显下降,差异有统计学意义(P <0. 05);起搏阈值、阻抗、R波振幅的测定值与电风暴前比较,无明显变化(P> 0. 05)。结论 ICD电风暴患者即刻阈值较电风暴前有所升高,即刻R波振幅、阻抗较电风暴前无明显变化,长期随访观察除颤电极参数稳定。Objective To investigate the stability of defibrillation electrode parameters after electrical storms(ES)in patients with implantable cardioverter defibrillator(ICD).Methods A retrospective study was performed on 65 cases of ICD patients after ES who were admitted from January 2010 to December 2016.The changes of defibrillation electrode parameters(threshold,impedance and R-wave amplitude)were compared before ES,immediately,3 months and 12 months after the ICD ES.Results The threshold of the defibrillation electrode immediately within 24 hours after ICD discharge was elevated than that before ES(P<0.05).The measured values of the R-wave amplitude after storm were slightly lower than those before storm,while there was no significant difference(P>0.05).No significant changes were found in impedance(P>0.05).Three and twelve months after ES,the pacing threshold was significantly lower than that immediately after the ES(P<0.05).There was no significant changes in electrode threshold,impedance and R-wave amplitude compared with those before ES during long-term follow-up(P>0.05).Conclusion The immediate threshold of patients with ES in ICD is higher than that before ES,there is no significant changes in other pacing parameters.Electrode parameters for defibrillation leads are stable during long term follow-up.

关 键 词：植入型心律转复除颤器 除颤电极 电风暴 电极参数 

分 类 号：R541.7[医药卫生—心血管疾病]