起搏器噪音反转功能的启动因素、心电图表现及处理

Starting conditions,ECG manifestations and management of pacemaker noise reversion

目的:阐述起搏器噪音反转功能的设计思想、启动因素、心电图表现及处理方法。方法:对5例植入心脏起搏器后发生噪音反转患者病例资料进行分析。结果:4例因发生快速心律失常而启动起搏器噪音反转功能,程控缩短起搏器心室后不应期可使其终止。1例因肌电位干扰而启动起搏器噪音反转功能,程控降低感知灵敏度并将感知极性改为双极可终止噪音反转。结论:噪音反转是现代起搏器的一种重要的保护性功能,其启动有心脏自身和心脏外2种因素,心电图表现与感知不良容易混淆,应认真鉴别并正确处理。

Objective To investigate the principle of pacemaker design, starting conditions, ECG manifestation and treating means about noise reversion. Methods Five cases implanted the pacemakers and started the function of noise reversion were analyzed. Results Four pacemakers in patients started the function of noise reversion due to tachycardia. The function was closed successfully after being programmed and postventricular refractory period was shortened. The other one started the function of noise reversion due to myoelectric potential interference. The function was closed successfully after being programmed and the polarity was changed to double. Conclusion Noise reversion is one of important protective functions. Cardiac and extra cardiac factors contribute to starting of the function. ECG manifestation and low sensitivity are easily confused. Therefore, identifying these factors exactly is important for dealing with noise reversion.