530例心房主动电极的临床应用

李燕萍; 郝应禄; 廖德荣; 蔡子奇; 杨玲; 钱宝堂

530例心房主动电极的临床应用

昆明医科大学第六附属医院玉溪市人民医院心内科

基金项目:

基金：云南省自然科学基金资助项目 (2013FZ258);

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出版历程
- 收稿日期: 2017-02-21

Clinical Application of 530 Atrial Active Electrodes

Funds:

基金：云南省自然科学基金资助项目 (2013FZ258);

摘要

摘要: 目的分析比较心房主动导线与被动导线的临床应用情况, 探讨心房主动电极导线的可行性与安全性.方法通过选取2002年1月至2016年3月在玉溪市人民医院植入起搏器治疗的患者1 027例.按患者选择意愿置入心房主动电极共530例为主动电极组, 心房被动翼状电极共497例, 为被动电极组, 记录患者心房电极植入时间;术中阈值下降时间;随访记录植入即刻、术后1周, 1月, 3月, 6月2组的阈值、阻抗;对比术后卧床时间、平均住院日以及脱位率、心房穿孔、囊袋感染、新发房颤等并发症;术后24 h行患者舒适度评分并记录.结果 (1) 心房主动电极组植入心房电极时间短于对照组; (2) 植入主动电极时, 螺旋旋入心肌后约需等待5~15 min, 平均 (4.38±2.62) min, 阈值可下降至可接受范围; (3) 在起搏参数方面, 植入主动电极手术中即刻阈值高于被动电极组而阻抗则低于被动电极组, 自术后1周半年, 主动电极组阈值及阻抗均低于被动电极组;参数长期稳定; (4) 术中发生气胸、心包填塞2组无明显差异, 而术中出血量及术中心房电极植入成功率主动电极组优于被动电极组; (5) 观察术后并发症, 囊袋血肿、感染、心包填塞2组无统计学差异, 而主动电极组电极脱位、尿潴留、肠麻痹发生率显著低于被动电极组; (6) 主动电极组在随访中, 新发房颤、房速的发生率减少; (7) 在植入主动电极后可以减少患者卧床时间、缩短患者平均住院日、改善患者感受.结论心房主动电极应用是安全可行的, 具推广应用价值.
- 起搏器 /
- 起搏导线植入 /
- 主动电极导线
Abstract: Objective To compare the clinical application of atrial active leads and passive leads, and to investigate the feasibility and safety of atrial active electrode lead. Me thods 1 027 patients with pacemaker implantation in Yuxi People's Hospital from January 2002 to March 2016 were selected. According to the patients' choice intention, 530 cases of atrial active electrodes were selected as active electrode group (n = 530) , and there were passive atrial electrodes in the passive electrode group (n = 497) . Then we record atrial electrode operative time, threshold fall time; followed up and recorded the threshold and impedance of the two groups immediately, 1week, 1 month, 3 months and 6 months after implantation. Bed time, average length of stay, comfort score and the rate of dislocation, atrial perforation, capsular infection, new atrial fibrillation were compared.Re s ults (1) Atrial active electrode group implanted atrial electrode time was shorter than control group. (2) The threshold fall time of atrial active electrode group was 4.38±2.62 minutes. (3) In pacing parameters, the threshold value of active electrode implantation was higher than that of passive electrode group while impedance was lower than that of passive electrode group on opration;After operation, the parameters of active electrode group were stable for a long time. (4) Pneumothorax and myocardial perforation had no significant difference between the two groups. (5) The incidence of electrode dislocation, urinary retention and intestinal paralysis in active electrode group was significantly lower than that in passive electrode group. (6) In the follow-up of active electrode group, the incidence of new atrial fibrillation and atrial tachycardia decreased. (7) After implantation of active electrode, patients' bed time was reduced, the average length of stay was shortened and patient's feeling was improved.Conclus ion The application of atrial active electrode is safe and feasible, and deserves promoton.
- Pacemaker /
- Lead implantation /
- Active fixation pacing leads

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参考文献(14)

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