5例超过90岁患者永久起搏器植入体会  

Experience of permanent pacemaker implantation in very old patients.

作　　者：王禹川[1] 黄波[1] 陈夏欢[1] 陈尔冬[2] 褚松筠[2] 丁燕生[2] 周菁[2] WANG Yu-chuan;HUANG Bo;CHEN Xia-huan;CHEN Er-dong;CHU Song-yun;DING Yan-sheng;ZHOU Jing(Department of Geriatrics,Peking University First Hospital,Beijing 100037,China;Departmentof Cardiology,Peking University First Hospital,Beijing 100037,China)

机构地区：[1]北京大学第一医院老年科,北京100037 [2]北京大学第一医院心内科,北京100037

出　　处：《中国心脏起搏与心电生理杂志》2021年第6期534-536,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的回顾长寿患者永久起搏器植入过程中遇到的问题。方法对2019年7月1日至2021年2月1日经笔者植入永久起搏器的、年龄≥90岁的长寿患者病历资料进行回顾。结果5例长寿患者接受永久起搏器植入治疗,年龄最大者96岁,平均年龄(92.6±2.3)岁,女性3例。平均随访6(3,18.5)个月,5例患者起搏器工作状态良好。与心房电极植入相比,心室电极植入相对容易,而心房内最佳起搏部位找寻困难。2例患者心房电极被锚定于心耳以外的部位。3例女性患者术中出现了不同程度的情绪烦躁及自我控制能力下降表现。结论在长寿患者植入永久起搏器过程中,应用心房主动固定电极和术中给予保护性约束是确保手术顺利完成的重要措施。Objective To review the problems encountered during permanent pacemaker implantation in very old patients.Methods Reviewing the medical records of patients aged≥90 years old,who refereed to authors department for permanent pacemaker implantation from July 1 st,2019 to February 1 st,2021.Results Five very old patients received the treatment of permanent pacemaker during the period.Of 5 patients,the oldest one was 96 years old,mean age of(92.6±2.3)years old,and 3 females were included.The mean follow-up time was 6(3,18.5)months,and all pacemakers were in good working condition.Compared with the procedure of implantation of atrial electrode,the procedure of ventricular electrode implantation was easier.It was atrial fibrosis that made procedure of finding the optimal pacing site in atrium difficulties.In 2 patients,the site of atrial electrode anchored was outside the auricle.Three female patients showed emotional irritability and decreased self-control with different degrees during the operation.Conclusions In the process of implantation of permanent pacemaker for very old patients,the application of active fixation atrial electrode and protective restraint during the procedure are important measures to ensure the success of the operation.

关 键 词：心血管病学 长寿患者 永久起搏器 主动固定电极 

分 类 号：R318.11[医药卫生—生物医学工程]