右室流入道间隔部植入起搏器的长期随访研究

Long-term Follow-up of Right Ventricular Inlet Septal Pacing

目的总结右室流入道间隔部起搏的长期随访情况。方法选择1998年10月—2010年10月我院收治的采用主动电极导线于右室流入道间隔部植入永久起搏器患者203例,术后进行随访并测定起搏阈值,询问患者导线相关并发症情况。结果本组203例患者成功植入192例,失败11例,植入成功率为94.6%;124例患者完成门诊随访,总随访时间为1～13年,平均(7.8±2.4)年;各随访时间点获得随访的患者起搏阈值比较,差异有统计学意义(F=69.08,P<0.01),大部分患者起搏阈值在术后短中期保持稳定。3例患者术后出现导线相关并发症,1例为心包刺激症状,1例为心脏压塞,1例为慢性起搏阈值增高。结论从长期随访结果来看,采用主动电极导线于右室流入道间隔部植入起搏器安全可行,大部分患者可在较长时间内保持稳定的起搏阈值。

Objective To review the long - term follow - up of right ventricular inlet septal pacing. Methods A to-tal of 203 patients who were implanted with permanent pacemaker in the right ventricular inlet septal using active electrode lead between October 1998 and October 2010 were included in the study. The pacing thresholds of the patients were determined, and the patients were followed up and asked about lead - related complications. Results The implantation of permanent pacemaker succeeded in 192 patients and failed in 11 patients, with success rate of 94. 6%. A total of 124 patients completed the follow - up （range 1 - 13 years; mean （7.8 ± 2.4） years]. The pacing thresholds differed significantly at different follow-up time points （F = 69. 08, P 〈0. 01 ）. Most patients had short-term or medium-term stable pacing threshold. Lead-related com-plications occurred to 3 patients, with one case of pericardial irritation, one of cardiac tamponade, and one of chronic pacing threshold increase. Conclusion Implantation of pacemaker in right ventricular inlet septal using active electrode lead is safe and feasible, and can help patients maintain stable pacing threshold in relatively long period of time.