主动固定电极行右室流出道间隔部起搏的临床分析

Clinical analysis of right ventricular outflow septal pacing with active fixation lead in the right ventricular outflow septum

目的比较右心室主动固定电极和被动电极的临床应用效果,探讨主动固定电极行右室流出道间隔部起搏的可行性和安全性。方法选择2008-12～2009-12采用主动固定电极行右室流出道间隔部起搏20例(RVS组)与同期应用被动电极行右室心尖部起搏20例(RVA组),分别比较两组患者术中及术后1个月起搏参数、术中右心室电极到位所需X线曝光时间以及术中及术后1个月并发症发生率。结果术中即刻及术后1个月随访起搏参数RVS组与RVA组比较差异无统计学意义(P>0.05)。右心室电极到位所需X线曝光时间RVS组稍长[RVS组为(315±69)s,RVA组为(213±43)s],但差异无统计学意义(P>0.05)。术中及术后两组均未发生手术相关并发症。结论使用主动固定电极进行右室流出道间隔部起搏是可行和安全的。

Objective To investigate the feasibility and safety in patients of fight ventricular outflow septal pacing （RVS） with active fixation lead in the right ventricular outflow septum compared with traditional right ventricular apex （RVA） pacing. Methods Forty patients received fully automatic dual chamber pacing （DDD） pacing were randomly divided into two groups, RVS pacing group and RVA pacing group. The pacing parameters in each group were analyzed during the operation and 1 month after the operation. X-ray exposure time in right ventricle electrode implantation and complications were compared between two groups. Results No significant difference was found in the instant and following-up pacing parameters at 1 month after the operation between two groups （P 〉 0. 05 ）. The Xray exposure time in fight ventricle electrode implantation was （315 ± 69 ）s in RVS pacing group and （213 ± 43 ）s in RVA pacing group and no significant difference was found between two groups （ P 〉 0. 05）. No complication was found either during the operation or during the following-up. Condusion RVS pacing is as safe and efficient as RVA pacing.