普通X光机安置永久心脏起搏器32例临床分析

Clinical Analysis of Implanting Permanent Pacemaker in General X-ray Machines:32 Cases Report

目的:观察应用普通X光机安置单、双腔永久起搏器及右室流出道主动固定电极安置的效果。方法:具备安置永久心脏起搏器指征的32例患者,经头静脉、锁骨下静脉或腋静脉,安置心房心室錨状电极或应用特殊塑形的眼镜蛇形钢丝安置右室流出道主动固定电极;在普通X光机正位直视下定位,结合起搏参数、心内电图特征,将起搏电极安置在预定位置。结果:6例右心耳及26例右心室心尖部錨状电极均能方便牢靠定位起搏;6例主动固定电极间隔部起搏3例,游离壁起搏1例,1例间隔部起搏15天后脱位自行固定于右室下壁稳定起搏,1例因固定困难改右室心尖部起搏。间隔部起搏定位时间,X光曝光时间明显延长。结论:安置心房心室被动錨状电极均能方便牢靠定位于右心耳及右心室心尖部稳定起搏;主动固定电极定位于右室流出道间隔部起搏固定尚有一定难度。

Objective：To observe the effect of implanting single lumen permanent pacemaker、double cavity permanent pacemaker and right ventricular outflow tract（RVOT） active fixation lead in general X-ray machines.Methods：32 cases Patients having permanent pacemaker indications were implanted atrial ventricular anchor electrode or used special modeling cobra wire in RVOT by cephalic vein、subclavian vein or axillary vein.Locating the position in general X-ray machines.Combining pacing parameters、characteristics of intracardiac electrocardiogram,implanted pacing electrode in the reservative position.Results：Right ventricular apex pacing in 26 cases、right atrial appendage in 6 cases can easily implant.Septum pacing in 3 cases and free wall pacing in 1 case all pacing successfully among active fixation lead pacing in 6 cases.1 case was dislocated and fixed stably under the right ventricular after 15 days.1 case was changed to pace in right ventricular apex because of fixing difficultly.Longer pacing time and X-ray exposing time in septum pacing.Conclusions：Implanting atrial ventricular passive anchor electrode can easily positioned at right atrial appendage and right ventricular apex reliably and pacing stably.The RVOT septum pacing with the active fixation lead have some difficulties now.