不同类型心房起搏电极的安置经验

Clinical Experience of lmplanting Atrial Pacing Leads

报告安置不同类型心房电极５６例的经验。其中螺旋电极２１根（内收式单极１１根、双极８根，暴露式单极２根），倒叉Ｊ形电极３５根。５６例的心房电极均于首次手术时安置成功，住院期间无电极脱位、心肌穿孔及阈值异常增高。随访期有１例患者倒叉电极移位；内收式螺旋单、双极电极和倒叉电极各有１例晚期阈值增高。严格遵守操作规程，将心房电极安置于右心耳并使Ｘ线和心电测试的指标及起搏参数达到可靠的要求，则有助于提高安置心房电极的成功率，并能减少电极移位和阈值升高。

In 56 pacing patients,19 retractable screw-in,2 unretractable screw+in and 35 tined J-shaped atrial leads were implanted successfully during operation.There were no dislodgements,perforation and excessive increase of pacing threshold during hospitalization.During follow-up.dysposition occurred in one tined J-shaped lead,increased pacing threshold in one screw-in unipolar and one bipolar lead,and one tined J-shaped lead respectively.Our experience shows that atrial leads may be implanted in the right atrial appendage,the indications of X-ray and the criteria of electrical measurements must be satisfied.This is very useful for increasing the success rate of implanting atrial leads and decreasing the leads dysposition and the rise of pacing threshold.