摘要
目的评价主动固定起搏导线的有效性及安全性。方法将2005年5月～2009年5月应用主动固定起搏导线患者为主动组,随机选择同期植入被动起搏导线的患者为被动组,随访3个月。对二组患者在植入时、植入后的起搏参数及安全性进行评价。结果①共有395例患者入选,主动组195例,被动组200例,其中主动组心房起搏58例,心室起搏195例,被动组心房起搏63例,心室起搏200例。二组手术时间接近,但主动组曝光时间较被动组明显延长。②主动组术中及术后1个月起搏阈值明显高于被动组,但3个月差异无显著性;术后1个月以及3个月主动组阻抗明显低于被动组。③主动组共有11例(5.6%)出现不良反应,其中导线心脏穿孔4例,心包炎2例,导线脱位3例,交叉感知1例,腰背痛1例;被动组共有7例(3.5%)出现不良反应,其中导线脱位4例(3例心房,1例心室),腰背痛2例,交叉感知1例。结论主动固定起搏导线在选择起搏部位较被动导线有明显的优越性,但其他较被动导线无明显优点,同时其可能发生严重的并发症,应严格掌握适应症,慎重使用。
【Objective】 To evaluate the efficiency and the safety of active-fixation pacing electrodes.【Methods】The patients,who accepted active-fixation pacing electrodes from May 2005 to May 2009,were defined as active-fixation group;the patients,who accepted passive-fixation pacing electrodes during the corresponding period,were selected randomly as passive-fixation group.All patients were followed up for 3 months.Pacing parameters and adverse effects were observed on the implantation,one month and 3 months after implantation.【Results】In the study,395 cases were enrolled,195 cases were in active-fixation group and 200 cases in passive-fixation group.In active-fixation group,58 cases accepted atrial pacing and 195 cases accepted ventricle pacing;and in passive-fixation group,63 cases accepted atrial pacing and 200 cases accepted ventricular pacing.There was no significant difference in the procedure time.But the time of X-ray exposure was significantly longer in active-fixation group.There was no significant difference in acute implant measurement except the threshold in active-fixation group was higher than that in the other group.After 3 months,the difference disappeared.Impedance in active-fixation group was significantly lower than that in the other group in 1 month and 3 months after implantation.The rates of adverse effect and dislocation were 5.6 % and 1.5 % respectively in active-fixation group,meanwhile 3.5 % and 2.0 % in passive-fixation group,there were no significantly differences between both groups.However,cardiac perforation occurred in 4 cases in active-fixation group.【Conclusion】Active-fixation electrodes are superior to passive-fixation electrodes in choosing pacing site,but no other superiorities are found over passive-fixation electrodes.Implantation of active-fixation electrodes should be prudently applied.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第6期882-885,共4页
China Journal of Modern Medicine
关键词
主动固定导线
起搏
脱位
心脏穿孔
active-fixation electrodes
pacing
dislocation
cardiac perforation
