螺旋电极在永久心脏起搏器中临床实践

摘要

目的 探讨永久心脏起搏器植入术中心房和心室螺旋电极的有效性和安全性.方法 回顾性收集我科2016年1月~2017年3月共57例需植入螺旋电极的患者,其中男性31例,女性26例,平均年龄65岁.植入成功后术中测试电极的阈值、阻抗、振幅及损伤电流.术后定期随访阈值、阻抗及振幅的变化及电极脱位或穿孔的情况.结果 57例成功植入螺旋电极的患者中:植入心室螺旋电极57根,心房螺旋电极41根.术中测试电极阈值、阻抗,R波或P波振幅,提示所有起搏器均正常植入且并无并发症.术后定期随访,起搏器工作正常,并无电极脱位或穿孔.结论 我们有限的临床经验提示,心室和心房的主动螺旋电极植入安全可靠,可成为植入起搏器的常规手术方式.%Objective To investigate the effectiveness and safety of atrial and ventricular screw-in pacing leads during permanent pacemaker implantation.Methods The patients needed to be implanted screw-in pacing leads (n=57, male 31, female 26 and average age=65) were chosen from the Beijing Anzhen Hospital of Capital University of Medical Sciences from Jan. 2016 to Mar. 2017. The threshold, impedance, amplitude and injury current of screw-in pacing leads were detected after successful implantation. The changes of threshold, impedance and amplitude, and dislocation or perforation of screw-in pacing leads were regularly followed up after the implantation.Results In 57 patients with successful implantation of screw-in pacing leads, there were 57 atrial screw-in pacing leads and 41 ventricular screw-in pacing leads. The detections of threshold, impedance and R or P amplitudes indicated that all pacemakers were successfully implanted and there were no complications observed. The regular follow-up showed that the pacemakers worked normally without dislocation or perforation of screw-in pacing leads.Conclusion The implantation of atrial and ventricular screw-in pacing leads is safe and reliable, which can be taken as a routine mode for pacemaker implantation.