自动夺获和阈值管理功能对起搏器输出电压的影响

Effect of auto-capture feature to ventricular pulse amplitude

目的探讨自动阈值管理及自动夺获功能对起搏器输出电压的影响,及不同夺获功能原理下起搏器输出电压的差异,以评估自动夺获功能对起搏器寿命的影响。方法分别选取植入自动夺获功能起搏器患者13例和植入无自动夺获功能起搏器患者20例进行临床随访。比较自动夺获功能组起搏器和无自动夺获功能组起搏器输出电压、脉宽等,并比较具有不同阈值夺获原理的起搏器之间输出电压的差异性。结果经统计分析表明具有阈值夺获功能起搏器组平均输出电压为(2.023±1.294)V,无阈值夺获功能起搏器组平均输出电压为(3.622±0.353)V,差异有统计学意义(P<0.01)。两组脉宽并比较差异无统计学意义(P>0.05)。虽然Medtronic公司的Kappa 700系列型起搏器平均起搏电压(2.485V)较ST.JUDE公司的Pacesetter ENTI-TYTM Model DC 5226或5130型起搏器平均输出电压(1.778V)高,但两组比较差异无统计学意义(P>0.05)。结论自动阈值管理或自动夺获功能可有效的减少起搏器输出电压不必要的损耗,节省起搏器电池能量,达到延长起搏器寿命的目的。

Objective To evaluate the influence of auto-capture feature to the ventricular pulse amplitude,and the difference of the ventricular pulse amplitude between two kinds of pacemakers with different auto-capture algorithm. Then,to evaluate the action of auto-capture on the pacemaker longevity theoretically. Methods Thirteen patients implanted pacemakers with auto-capture function and twenty patients without auto-capture function were all followed up. The parameters such as pulse amplitude, pulse width, pacing threshold and the activity auto-capture function were all obtained from the programmer. Then to compare the pulse amplitude and width of these two groups, also do the pacemakers with different auto capture algorithm. Results The mean pacing amplitude of pacemakers with auto-capture was （2. 023±1. 294）V,and that of pacemakers without auto capture was （3. 622±0. 353）V, （P〈 0.01） ,which indicated that there was a significant difference between these two groups. There was no significant difference for pulse width （P〉0.05）. Although the mean of pulse amplitude in Kappa 700 series （2. 485V） was higher than the of Pacesetter ENTITYTM model DC 5226 or 5130 （1. 778V） ,there was no difference between that two groups （P〉0.05）. Conclusion Capture management or auto capture feature can effectively decrease the consumption of unnecessary pulse amplitude, save the power of battery and prolong the pacemaker longevity.