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1、西北國防醫(yī)學(xué)雜志(MedJNDFNC)2006Jun.;27(3)173#論著#起搏器更換時原起搏電極導(dǎo)線參數(shù)及更換指標(biāo)分析張衛(wèi)澤,馬凌,胡靜泠,秦勉,王艷春,張明旭,陳永清,杜修海(蘭州軍區(qū)蘭州總醫(yī)院心血管內(nèi)科,甘肅蘭州730050)摘要:目的:分析74例更換起搏器時電極導(dǎo)線的各項參數(shù)的變化并探討導(dǎo)線更換指標(biāo)。方法:本組年齡12~87(62.8?18.4)歲,其中病竇綜合征45例,房室傳導(dǎo)阻滯29例,均為單腔VVI起搏。結(jié)果:至測量時原心室起搏電極導(dǎo)線的埋置時間60~148(97.4?22.8)月,首次埋置時起搏
2、閾值為(0.48?0.24)V,更換時為(1.29?0.64)V(P﹤0.01),增加0.81V,增幅為168%,首次植入時R波幅為(7.8?3.6)mV,更換時為(5.9?3.4)mV(P﹤0.05)。植入時電極導(dǎo)線阻抗為(664?122)8,更換時阻抗為(726?148)8,增幅9.3%(P﹥0.05)。7例因起搏閾值大于2.0V或阻抗大于12508而重新植入電極導(dǎo)線。原電極導(dǎo)線使用率為90.5%。結(jié)論:埋置起搏電極導(dǎo)線8~9年后,90.5%原電極導(dǎo)線仍在可使用的范圍內(nèi),能否支持到再次更換需進(jìn)一步隨訪。關(guān)鍵詞:
3、起搏器;起搏電極導(dǎo)線;起搏閾值;電極導(dǎo)線阻抗中圖分類號:R541文獻(xiàn)標(biāo)識碼:A文章編號:1007-8622(2006)03-00173-03AnalysisofrelatedparametersofimplantedventricularleadsduringtheprocessofpulsegeneratorreplacementandimplicationforleadsreplacementZHANGWei-ze,MALin,HUJing-ling,etal.(DepartmentofCardiology,L
4、anzhouGeneralHospita,lLanzhouCommand,PLA,Lanzhou700050,China)Abstract:Objective:Toanalyzetheparametersofimplantedventricularleadsin74patientsreceivingpulsegeneratorreplacement.Methods:Pulsegeneratorswerereplacedin74patients(male41andfemale33cases;meanage:62.8?
5、18.4years).Amongthe74patients,45weresicksinussyndromeand29weresecondtothirddegreeatrioventricularblock.AllofthepacingmodeswereVVI.Results:Implantedventricularleadshadbeenimplantedfor97.4?22.8(from58to179)monthsuntilpulsegeneratorswerereplaced.Theinitialpacingt
6、hresholdofleadswas(0.48?0.24)V.Onthetimetoreplacepulsegenerator,thethresholdincreasedby168%andreached(1.29?0.64)V,(P<0.01)withthemeanincreasevalueof0.81V.Comparedwiththeinitialparameters,Rwaveamplitudedecreasedsignificantlyduringpulsegeneratorreplacement(7.8?3
7、.6)mVvs(5.9?3.4)mV,(P<0.05).Theleadimpedanceshadnosignificantchangecomparedtoinitialimpedance(726?148)8vs(664?122)8,(P>0.05).Newleadswereimplantedin7patientsduetotheoriginalleadthresholdover2.0Vorimpedanceover12508.Sixty-seven(90.5%)oldleadswerecontinuedtoperf
8、ormthepacingfunction.Conclusion:Relatedparametersof90.5%leadswerenormalwithin8to9yearsafterimplantingventricularleads.Thefollow-upshouldbetakentojudgewhetherthesecondleadreplacemen
