铱分型镀覆和激素释放电极导线起搏参数的动态变化

Compare of Parameter Between Fractally Iridium Coated Lead and Steroid Eluting Lead.

为探讨激素释放电极导线(steroid eluting lead,SEL)和铱分型镀覆电极导线(fractally iridium coated lead,FICL)的起搏阈值和阻抗的变化,本研究回顾分析了2种导线术中、术后1和3个月的起搏阈值和阻抗的变化情况,并进行了比较。2001年1月～2003年12月置入的各种起搏器495台及配套的各类心房、心室起搏导线717根,其中509根为SEL,另208根为FICL。结果:FICL组术中起搏阈值显著低于SEL组(0.40±0.24V vs0.46±0.27V,P<0.05),术后1和3个月FICL组也低于SEL组,但无显著意义。FICL组术中阻抗显著高于SEL组(843±382Ωvs524±210Ω,P<0.01)。术后1和3个月也高于SEL(分别为714±263Ωvs520±241Ω;694±176Ωvs515±227Ω,allP<0.05)。结论:SEL和FICL均为低能量起搏电极导线,并可大幅度降低起搏能量消耗。FICL的感知和起搏功能可长时间保持稳定,并具有独特的感知优势。

The lead is very important to the energy consumption and the life of pacemaker. It has been proved that steroid eluting lead（SEL） has the advantages of low energy-consumption, long life-span and safe pacing. But there are few studies about Fractally iridium coated lead（ FICL）. The study compared the threshold and impedance between SEL and FICL during implantation, 1 month and 3 months after implantation in 495 patients with pacemarker which there were 717 different kinds of artial and ventricle leads,including 509 SEL and 208 FICL. Result： The pacing threshold of FICL was significantly lower than that of SEL during implantation （0.40 ± 0.24V vs 0.46 ± 0.27V, P 〈 0.05 ）. But there were no significant difference between the two kinds of leads at 1 month and 3 months after implantation. The impedance of FICL was significantly higher than that of SEL during implantation （843 ±382Ω vs 524 ± 210Ω,P 〈0.01 ）. The former was also higher than the latter at 1 month（T14 ± 263Ω） and 3 months（694 ± 176Ω） after implantation（ all P 〈 0.05 ）. Conclusion： SEL and FICL are both low energy lead and can decrease the pacing energy consumption significantly. FICL can maintain long-term and stable sensing and pacing function, it has the advantage of sensitivity especially.