右心室流出道间隔部和心尖部主动电极植入2年随访安全性分析

Safety of Active-fixation Lead Implanted in the Right Ventricular Outflow Tract Septum and Ventricular Apex:A Two-year Follow-up

目的探讨右心室流出道间隔部和心尖部主动电极起搏的长期安全性。方法回顾性分析我院2006年2月—2007年7月101例右心室起搏患者的主动电极指标,其中右心室流出道间隔部起搏54例,右心室心尖部起搏47例。术后随访2年,测定右心室主动电极的阈值、R波高度和阻抗,比较两组有无差异。结果两组患者术后3、6、12、24个月起搏阈值和阻抗与术后即刻比较,差异均有统计学意义(P<0.05),术后3个月起搏阈值和阻抗保持平稳。R波高度在术后即保持稳定。两组心室起搏阈值、R波高度和阻抗同时段比较,差异均无统计学意义(P>0.05)。两组患者无起搏和感知不良,无阻抗过高。结论主动电极在右室流出道间隔部起搏和右室心尖部起搏相比,同样长期安全有效。

Objective To explore the long-term safety of the active fixation lead implanted in the right ventricular outflow tract septum （RVOT） and right ventricular apex （RVA）.Methods The indexes of 101 patients were analyzed retrospectively who underwent pacemaker implantation from February 2006 to July 2007 with ventricular lead placement on the RVOT septum （n=54） or RVA （n=47）.Post-operation follow-up was conducted for two years.Information on stimulation thresholds,R-wave sensing,and lead impedances were collected and compared between the two groups.Results Compared with the moment of operation,3,6,12 and 24 months after the operation,pacing threshold and impedance were statistical significance （P0.05）.Pacing threshold and impedance remained stable 3 months after the operation.R-wave sensing remained stable the moment of post operation.There was no significant difference between the two groups in pacing threshold,R-wave sensing and impedance at the same period （P0.05）.No case of high pacing thresholds,inadequate sensing,and hyper-impedance was found.Conclusion The active-fixation leads placed on the RVOT septum is as long safe as that on the RVA.