采用主动电极行右心室起搏的临床价值

The Clinical Value of Active Leads in Right Ventricular Pacing

目的观察主动电极在右心室起搏中的临床应用价值。方法选择需要安置心脏起搏器患者65例，其中男29例，女36例，年龄41～85（69．6±18．8）岁。患者为缓慢性心律失常或者严重心力衰竭。主动电极41例，其中，主动电极间隔组19例，电极固定部位为右心室间隔部；主动电极心尖组22例，电极固定部位为右心室心尖部。被动电极组24例，电极固定部位为右心室心尖部。结果主动电极间隔组、主动电极心尖组与被动电极组即刻起搏参数比较无明显差异（P〉0．05）。在出院后2，6个月随访起搏阈值与置入时比较也无差异，但有1例出现被动电极脱位，、主动电极间隔组置入时间和曝光时间较被动电极组、主动电极心尖组延长（P〈0．05），被动电极组与主动电极心尖组置入时间和曝光时间比较差异无显著性（P〉0．05）。结论使用主动电极进行右心室起搏（无论心尖部还是室间隔部起搏）都是安全、可靠的。

Objective To observe the Sixty-five patients with bradycardia or severe heart clinical value of active lead in right ventricular pacing. Methods failure （ 29 male and 36 female,41 - 85 years, average 69.6±18.8 ） who received cardiac pacing therapy were enrolled in the study. Active leads were used in 41 patients and they were implanted in right ventrieular septum in 19 patients while other 22 patients＇implantahle site was right ventricular apex. All the passive leads wet~ implanted in the right ventricular apex in 24 patients. Results There was no significant difference in pace parameter among the active leads in septum,active leads in apex and passive leads ill apex groups{ P 〉 0.05）. The pace threshold was also not significant different after 2,6 months follow-up compared with the moment when the leads were implanted;however, 1 passive lead dislocated during follow up. The operation time and exposure time of active leads in septum group were significantly longer than that of the other two groups（P 〈 0.05） ;The operation time and exposure time between active leads in septum and passive leads group was not significantly different （ P 〉 0.05 ）. Conclusion Right ventricular pacing（ either in apex or septum） with active leads was safe and reliable in clinical practice.