老年患者起搏器置入术后主动固定电极参数可变性分析

Variability of active fixation lead parameters in elderly patients after pacemaker implantation

目的比较老年患者起搏器置入术后主动固定电极参数的变化情况。方法入选62例接受主动固定电极置入的患者,将电极固定于右心室流出道间隔部33例作为流出道间隔组,右心室心尖间隔部29例作为心尖间隔组,分别于术中、术后48h和3个月测定起搏阈值及电极阻抗,分析其变化情况。结果 2组患者术后48h电极阻抗较术中明显下降(P<0.05),术后3个月较术后48h明显下降(P<0.05)。流出道间隔组术后3个月起搏阈值较术中及术后48h有升高趋势,但差异无统计学意义(P>0.05),心尖间隔组术中、术后48h及3个月起搏阈值无明显变化(P>0.05)。2组起搏阈值及电极阻抗比较,差异无统计学意义(P>0.05)。结论老年患者起搏器置入术中主动固定电极起搏阈值在术后3个月无明显变化,电极阻抗逐渐降低。

Objective To compare the variability of active fixation lead parameters in elderly pa- tients after pacemaker implantation. Methods Sixty-two patients who underwent active fixation lead implantation were divided into right ventricular septum outflow tract group （n=33） and right ventrieular apex outflow tract group （n=29）. Their pacing shreshold and lead impedance were measured during operation,48 h and 3 months after oeration,respectively. Results The lead im- pedance was significantly lower in the two groups 48 h after operation than during operation and 3 months after operation than 48 h after operation （P〈0.05）. No significant difference was found in the pacing threshold of right ventricular septum outflow tract group although it was higher 3 months after operation than 48 h after operation （P〉0.05）. No significant difference was found in the pacing threshold of right ventricular apex outflow tract group during operation,48 h and 3 months after operation （P〉0.05） and in the pacing threshold and lead impedance between the two groups （P〉0.05）. Conclusion No significant change of the pacing threshold of active fixa- tion leads occurs while the lead impedance decreases gradually in elderly patients after pacemaker implantation.