永久起搏器主动固定电极导线的长期随访观察
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The long-term follow-up study of active-fixation leads in potients with permanent pacemaker
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    摘要:

    目的观察主动固定电极导线的长期参数变化,并探讨其应用的稳定性。方法2006年1月至2007年8月在沈阳军区总医院植入永久起搏器并置放主动固定电极导线的患者124例(共心房电极1根,心室电极124根),其中男67例,平均年龄为(69±9)岁。植入部位:右心耳1例,室间隔93例,心尖部31例。测试手术后即刻及术后1、3、6、12个月的参数变化。结果参数变化:起搏阈值:手术即刻增高,术后1个月下降,两者有显著的统计学差异,术后3、6、12个月起搏阈值与术后1个月比较无明显改变。感知:手术即刻与术后多次随访均无明显变化。阻抗:手术即刻增高,术后随访各个月的阻抗均较手术即刻的阻抗低,与术中比较有显著统计学差异。2例患者在术后6个月时阈值升高。结论主动固定电极导线固定较牢固,脱位率低于被动固定电极导线,术后阈值升高发生率较低(1.6%),长期观察参数均较稳定。

    Abstract:

    Objective To observe the long-term change of parameters of active-fixation lead and to explore its stability. Methods Totally 124 patients 67 males,mean age (69±9) yearsreceived implantation of the permanent pacemakers and the active-fixation leads (1 atrial active-fixation lead,124 ventricular active-fixation leads) from Jan,2006 to Aug,2007. The implantation sites were as follows: 1 in the right atrial appendage,66 in ventricular septum,58 in ventricular apex. The parameters were recorded immediately,1-month,3-months,6-months and 12-months postoperatively. Results The pacing thresholds increased during operations and decreased 1 month postoperatively. There was significant statistical difference between the two time points. There was no significant difference between time points of 1 month,3 months,6 months and 12 months postoperatively. The sensitivity was not significantly different between all time points. Impedances increased during operation and decreased postoperatively. The pacing thresholds increased in 2 patients (1.6%) 6 months after operation.Conclusion The active-fixation lead is more stable than passive-fixation leads,and the dislocation rate of active-fixation lead is comparatively lower. The incidence of threshold rising is low (1.6%),and the pacing parameters are stable postoperatively.

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王秋菊 王冬梅 臧红云 于海波 韩雅玲.永久起搏器主动固定电极导线的长期随访观察[J].中华老年多器官疾病杂志,2009,8(6):533~535

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