摘要
目的总结永久起搏器心外膜植入术后当天、短期术后和长期术后心外膜电极导线的心室阈值的变化,分析心外膜植入起搏器是否安全、稳定。方法入选2007年10月至2016年3月在阜外医院行心外膜永久起搏器植入术,且出院后进行1次及以上程控随访的43例患者。成人患者7例,其中3例心脏再同步治疗(CRT)左心室导线心外膜植入,4例VVI永久起搏器心外膜植入;儿童患者36例,均为复杂先天性心脏病术后行心外膜永久起搏器植入术。统计程控中获得的心室阈值结果并进行回顾性分析。结果平均随访3~96个月。结果显示心外膜导线植入术后当天平均心室阈值为(2.7±1.2)V/0.5 ms。出院前术后1~16 d再次测试心室阈值为(1.2±0.5)V/0.5 ms。出院后1年内随访心室阈值为(1.0±0.4)V/0.5ms,12~36个月心室阈值为(1.3±1.1)V/0.5 ms,36个月以上心室阈值为(1.5±0.6)V/0.5 ms。3例心外膜导线植入CRT的患者随访(39±31)个月,左心室阈值术后当天为(3.9±3.2)V/0.5 ms,出院前术后1~16 d再次测试心室阈值为(1.67±0.14)V/0.5 ms,36个月以上心室阈值(1.1±0.4)V/0.5 ms。成人与儿童心外膜电极导线阈值变化一致。结论术后当天,心外膜导线心室阈值明显高于心内膜电极导线,术后1周左右心外膜导线心室阈值回落且能维持长期稳定。心外膜永久起搏器植入在成人儿童患者都安全、稳定。
Objectives To summarize the experience of implanting for permanent epicardial pacemakers and to explore the stability of ventricular capture threshold in intraoperative, short-term and long-term postoperative programming. Methods A total of 43 patients implanted permanent epicardial pacemakers between October 2007 and March 2016 in Fuwai Hospital were included in this study.All the 43 patients were followed up for 1 or more times after operations.Among them, 7 were adult patients[3 cases of cardiac resychronization therapy (CRT) with left ventricular epicedial lead implantation, 4 case implanted permanent epicardial pacemakers with VVI modal], and 36 were children who were implanted permanent epicardial pacemakers after complicated cardiac surgery.The ventricular capture thresholds were obtained and analyzed retrospectively. Results The patients were followed-up for 3-96 months.The average ventricular capture threshold was (2.7±1.2) V/0.5 ms during epicardial lead implantation.The mean ventricular capture threshold was (1.2±0.5) V/0.5 ms at 1-16 days before discharge.The mean ventricular capture thresholds were (1.0±0.4) V/0.5 ms,(1.3±1.1) V/0.5 ms, and (1.5±0.6) V/0.5 ms at 1 years, 1-3 years, and above 3 years, respectively.For 3 patients of CRT with left ventricular epicedial leads implantation, the average follow-up was (39±31) months.The left ventricular capture threshold was (3.9±3.2) V/0.5 ms during implantation.The mean ventricular capture threshold were (1.67±0.14) V/0.5 ms, and (1.1±0.4) V/0.5 ms at 1-16 days before discharge and 3 years, respectively.The change trends of the epicardial ventricular capture threshold in adults and children were consistent. Conclusions The ventricular capture thresholds of epicardial leads were significantly higher than those of the endocardial leads during operation.Nevertheless, the ventricular capture threshold decreased at 1 weeks after operation and maintained long-term stability.Epicardial permanent pacemaker implantation was safe and ventricular capture th
作者
陈伟
花中东
赵爽
戴研
华伟
张澍
陈柯萍
Chen Wei;Hua Zhongdong;Zhao Shuang;Dai Yan;Hua Wei;Zhang Shu;Chen Keping(Center of Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China;Third Ward of Pediatrics Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing 100037, China;Department of Internal Medicine, Qinghe Branch Hospital of Beijing Bureau of Prison Administration, Tianjin 300481, China)
出处
《中华心律失常学杂志》
2019年第2期160-164,共5页
Chinese Journal of Cardiac Arrhythmias
