具有阈值夺获功能的双腔起搏器临床应用及观察  

Clinical Applicaton and Observation of Daul Chamber Pacemaker with Ventricular Auto-capture Funtion

作　　者：韩雪更[1] 徐亚伟[1] 陈艳清[1] 杨海燕[1] 于学靖[1] 周可[1] 

机构地区：[1]同济大学附属铁路医院心内科,上海200072

出　　处：《同济大学学报（医学版）》2003年第6期483-485,共3页Journal of Tongji University(Medical Science)

摘　　要：目的 观察具有阈值夺获功能的双腔起搏器参数变化,提取储存数据协助临床诊断并评估其安全性。方法2001年12月-2002年10月植入具有阈值夺获功能的双腔起搏器20例,观察术中、术后1个月、3个月、6个月参数,包括心室阈值、输出电压、阻抗、心室除极波的感知值(ER振幅)、极化电位,自动模式转换功能,心率事件统计,睡眠功能等。结果 18例能打开自动阈值夺获功能,使输出电压在0.96±0.18 v左右,6个月中各项参数变化平稳,随访期间功能正常,无起搏脱落现象;1例术中极化电位正常,能打开这一功能,术后一周发现极化电位升高,以后未能打开这项功能;1例频发室早、房颤,心房感知不良。6例发生房颤,持续时间1min至3h不等,均转为DDI模式;观察到窦房结变时性功能不良10例;静息频率工作状态时患者无不适。结论 自动阈值夺获功能双腔起搏器节约能量寿命延长,安全可靠,符合患者生理需要;具有多种功能,提供相关资料。Objective To observe the parameter changes of dual chamber pacemaker with ventricular auto-capture function, to help clinical diagnosis and safety evaluation by studing saved data. Methods 20 dual chamber pacemaker with ventricular auto-capture function were implanted from November 2001 to October 2002, and the data during the periods of implantation procedure, the 1st month after operation,the later 3rd and 6th months, which included stimulation threshold, output amplitude, evokedresponse(ER), impendance and polarzing potential, automatic modeswitch function, heart rate event statistic,sleeping funtion were observed. Results Ventricular autocapture function of 18 patients could work nor-mally,output amplitude fluctuated 0.96 ±0.18 v,all parameters changed placidity in the period of 6 months,and all funtion worked well,Missing pace was not found;polarzing potential of 1 patient was normal in implantation procedure, and this function was opened,But the 1st week after opertion the polarzing potention rised,and the function was not opened. In 1 patient there was frequent ventricular beat and atrial fibrillation and atrialapperceive badness. Automatic mode switch funtion was observd in 6 patients in response to atrial fibrillation,lasting from 1 min to 3 time,and inverted into DDI 10 patients sinoatrial node badness was observation. Conclusion Dual chamber pacemaker with ventricular autocapture funtion can economize energy,offer safe and credibility.

关 键 词：双腔起搏器 自动夺获 自动模式转换 

分 类 号：R541.7[医药卫生—心血管疾病]