永久起搏器安置术后的动态起搏心电图分析

Analysis of the dynamic electrocardiography after permanent pacemaker implantation

目的了解永久起搏器安置术后起搏器的正常起搏功能、起搏功能障碍及可能发生的自身心律失常。方法分析84例永久起搏器安置术后随访者的动态起搏心电图。结果①83%为正常起搏功能,包括室性融合波和假性室性融合波;双腔起搏器中的上限频率+模式转换、心室安全起搏;单腔起搏器中的起搏器滞后功能;电张调整性T波改变;②17%起搏功能障碍,包括室房逆传、起搏功能异常、感知功能异常、起搏器介导性心动过速;③81%出现自身心律失常,包括室性早搏、房性早搏、心房纤颤、短阵房性心动过速、短阵室性心动过速。结论安置永久起搏器后起搏心电图变得复杂,只有对正常起搏及起搏器故障的心电图做出正确判断,才能及时正确处理,以避免起搏器故障造成严重后果。

Objective To investigate the pacing function,the pacing dysfunction and the autologous arrhythmia after permanent pacemaker implantation. Methods 84 cases of permanent pacemaker implantation were involved and the dynamic electrocardiography was investigated. Results ①83% of the cases showed normal pacing function including ventricular fusion wave,pseudo ventricular fusion wave,automatic mode switching in dual-chamber pacemakers,ventricular safety pacing,hysteresis function in the single-chamber ventricular pacemaker and electrotonic modulation of the T wave and cardiac memory.②17% of the cases showed abnormal pacing function including pacing failure,sensing abnormality,ventricular atrial conduction and pacemaker mediated tachycardia.③81% of the cases showed autologous arrhythmia including premature ventricular beats,premature atrial beats,auricular fibrillation,transient atrial tachycardia and non-sustained ventricular tachycardia. Conclusion The dynamic electrocardiography after permanent pacemaker implantation became very complicated.Only correctly judging pacing functions,can we just deal with the pacemaker malfunction correctly in time.