摘要
目的通过对比分析起搏器导线植入位点的双源CT、DSA图像特点，探讨改进室间隔起搏器导线的植入方法。方法入选50例按照传统方法将起搏器导线植入至右心室间隔的病例，行双源CT检查，了解起搏器导线的精确位置，同时对照分析该患者的植入术中DSA图像。结果50例患者通过双源CT均清晰显示了心脏室间隔的解剖结构以及起搏器导线的位置，成功率达100％。植入游离壁13例，占26％；前间隔3l例，占62％；中间隔6例，占12％。根据双源CT显示的起搏器导线位置将患者分成两组：室间隔组和游离壁组。分析左前斜（LAO）45°时，右心室起搏器导线固定于心室的头端和导线跨瓣处的成角角度，室间隔组（26．8°±5．2°）比游离壁组（2．6°±2．6°）明显大，差异具有统计学意义。结论双源CT可以成功地显示起搏器导线的精确位置，LAO45°时室间隔组成角角度比游离壁组更大。预测能植入到右心室间隔的临界（cutoff）角度为13．5°，该点的特异性为90％，敏感性为87．5％。
Objective To investigate the positioning of double source computerized tomography（DSCT） on implantation of the pacemaker and lead. Methods Fifty patients were included in this study, and they were received the DSCT examination after the implantation of pacemaker. And the DSA images during operation were analyzed. Results All patients received the DSCT examination and the rebuilding of the ventricular septum. The lead was implanted on the free wall of right ventricular in 13 patients, and on the ventricular septum of right ventricular in 31 patients. On the LAO 45°position,the angular formed by line A that connected with the position of the lead and the lead cross the tricuspid valve, and line B that vertical the horizontal cross the tricuspid valve was measured. The angular was much bigger in ventricular septum group（ 26. 8°± 5.2°） than the free wall group（2. 6° ±2. 6°）. Conclusion DSCT is useful to rebuild the ventricular septum and show the position of the lead of pacemaker. But it is better to combine with other techniques in guiding the implant the pacemaker and lead. Tile cutoff value of the angular that could judge the lead position in the ventricular septum was 13.5°, and the sensitivity was 87.5% ,and specificity was 90%.
出处
《中华心律失常学杂志》
2011年第2期103-106,共4页
Chinese Journal of Cardiac Arrhythmias
基金
浙江省重大科技专项课题（2009C03013-1）
关键词
双源CT
室间隔起搏
Double source computerized tomography
Ventricular septum pacing
